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Robert L. Spitzer, MD; Jean Endicott, PhD; Jacob Cohen, PhD; Joseph L. Fleiss, PhD

Arch Gen Psychiatry. 1974;31(2):197-203.

Abstract
Issues in the constraints on the validity of computerized psychiatric diagnosis are illustrated by the analysis of diagnoses produced by treating clinicians, expert diagnosticians, and the DIAGNO III computer diagnostic system. The results indicate modest agreement between the computerized diagnoses and both clinicians and experts, and not much better agreement between the experts and between the treating clinicians. The main constraint on the validity of computerized diagnoses is not in any inherent limitation on computer processing but rather in the limitations of the current diagnostic system itself. Improvements in computer diagnosis await improvements in the diagnostic system, along the lines of simplification, explicit criteria, and limitation of the categories to those conditions for which validity evidence exists.

Author Affiliations
From Biometrics Research, New York State Department of Mental Hygiene, New York State Psychiatric Institute; and the departments of psychiatry (Drs. Spitzer and Endicott) and biostatistics (Dr. Fleiss), Columbia University; and the Department of Psychology (Dr. Cohen), New York University.

Footnotes
Accepted for publication March 28, 1974.

Reprint requests to the New York State Psychiatric Institute, 722 W 168th St, New York, NY 10032 (Dr. Spitzer).

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