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International Journal of Epidemiology 2003;32:1078-1080
© International Epidemiological Association 2003

Theory and Methods

Commentary: Two-phase surveys. A death is announced; no flowers please

Martin Prince

Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. E-mail: m.prince@iop.kcl.ac.uk

The first 150 words of the full text of this article appear below.

Roseanne McNamee1 has demonstrated elegantly that the efficiency of a two-phase design is critically dependent upon the sensitivity and specificity of the phase one screening assessment. More importantly, regardless of the ratio of costs of phase one and phase two assessments, two-phase designs will never be justified on the grounds of efficiency, unless the screening assessment is unusually accurate. She provides an evidence-based rule of thumb; sensitivity and specificity summed together need to exceed 1.6, or, allowing room for doubt as to whether cited validity coefficients will generalize to other settings, 1.7. Thus, McNamee has performed a service for psychiatric and neuroepidemiology, deftly inserting a stiletto between the ribs of a design that has proved enduringly popular but that is all too often incorrectly applied, analysed, and inferenced.2,3

At first sight, McNamee’s rule of thumb would still rule into contention many commonly used screening assessments. For dementia, the Mini-Mental State . . . [Full Text of this Article]


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