Sensitivities and specificities of questionnaires and clinical signs and symptoms to predict daily life impairment after SARS-CoV-2 infection varied across different health sectors
Year: 2025
Type: article
Abstract: To investigate the impact of patient selection in different health sectors on sensitivities and specificities of psychosomatic questionnaires and clinical signs and symptoms (CSS) for predicting daily life impairment (DLI) in individuals after SARS-CoV-2 infection. Secondary data analysis of three independent cross-sectional surveys in general population ( n = 2828), fourteen primary care practices ( n = 204), and rehabilitation hospital ( n = 161). DLI and symptoms were captured using questionnaires. PHQ-15 (Patient Health Questionnaire-15) and SSD-12 (Somatic Symptom Disorder-12), PHQ-2 (Patient Health Questionnaire-2), GAD-2 (Generalized Anxiety Disorder-2), and FAS (Fatigue Assessment Scale) were used to assess somatic symptom disorder (SSD), depression, anxiety and fatigue. Diagnostic indices were calculated to predict DLI. The sensitivities of questionnaires and CSS increased, and specificities decreased from general population to practices and hospital. SSD-12 had a higher diagnostic odds ratio (dOR; 95 % confidence interval) (17.4; 12.6–24.0) in population than in practices (8.4; 3.6–19.7) or hospital (8.1; 1.7–31.7). FAS > 22 had higher dOR (15.0; 11.8–19.1) in population than in practices (5.3; 2.8–9.8) or hospital (4.8; 1.4–16.3). The pattern (population / practice / hospital) was similar in depression (9.2; 7.0–12.0 / 8.0; 3.6–18.1 / 12.2; 1.5–96.2) and anxiety (8.0; 6.0–10.8 / 2.4; 1.0–5.6 / 3.0; 0.6–14.1). Areas under the curves of questionnaires were highest in population, followed by hospital, and consistently lower for practices. There is a large variation in sensitivities and specificities to predict DLI. The extent to which SSD or psychosomatic comorbidity contributes to DLI varied across the health sectors in which patients are diagnosed and treated. • Sensitivities of questionnaires to predict impairment increase across health sectors. • Specificities of questionnaires decrease from population to practices to hospital. • The diagnostic pattern favors aspects of somatization in the general population. • Diagnostic patterns seemed pathognomonic in hospital and inconsistent in practice. • Extent to which somatisation adds to life impairment varied across health sectors.
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,760
OpenAlex ID: W4415938521