JAMA Review Finds Diagnostic Interviews Less Reliable
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- JAMA Network Open published a review (Feb 2024‑Sep 2025) that measured test‑retest reliability of mental‑health diagnostic interviews using Cohen’s κ.
- Laura Duncan noted that while diagnostic interviews are treated as a “gold standard,” the study found they lack a definitive benchmark for validity and reliability.
- Cohen’s κ scores showed higher reliability for substance‑use disorders, with opioid use disorder achieving the highest consistency across repeat interviews.
- Dr. Michael First criticized the review for not identifying which specific interview tools (e.g., SCID, Mini, CAPS) are most reliable and for grouping fully‑ and semi‑structured formats.
- SCID and other tools such as Mini and CAPS were evaluated, illustrating the study’s limited data on individual tool performance.
Why it matters: Clinicians and researchers lose confidence in current diagnostic interviews as a definitive benchmark, while patients risk misdiagnosis; the study pushes the field toward seeking more reliable assessment tools.
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