Screening four broad categories of eating disorders: suitability of a clinical algorithm adapted from the SCOFF questionnaire

Abstract

BackgroundWe evaluated the performance of a clinical algorithm (Expali™), combining two or more positive answers to SCOFF questionnaire with Body Mass Index (BMI), to identify four Broad Categories of eating disorders (ED) derived from DSM-5.MethodsThe clinical algorithm (Expali™) was developed from 104 combinations of BMI levels and answers to five SCOFF questions with at least two positive answers. Two senior ED physicians allocated each combination to one of the four Broad Categories of ED derived from DSM-5: restrictive disorder, bulimic disorder, hyperphagic disorder and other unspecified ED diagnosed by ED clinicians. The performance of Expali™ was evaluated on data from 206 patients with ED. Sensitivity, specificity values and Youden index were calculated for each category.ResultsThe 206 patients were diagnosed as follows: 31.5% restrictive disorder, 18.9% bulimic disorder, 40.8% hyperphagic disorder and 8.8% other ED. The sensitivity of Expali™ for restrictive, bulimic, hyperphagic and other unspecified ED were respectively: 76.9, 69.2, 79.7 and 16.7%. The Youden index was respectively 0.73, 0.57, 0.67 and 0.07.ConclusionsIn a SCOFF-positive ED population (at least two positive answers), the clinical algorithm Expali™ demonstrated good suitability by correctly classifying three of the four Broad Categories of eating disorders (restrictive, bulimic and hyperphagic disorder). It could be useful both to healthcare professionals and the general population to enable earlier detection and treatment of ED and to improve patient outcomes.

Eating-Disordered Behavior in Adolescents: Associations with Body Image, Body Composition and Physical Activity

“…Losing weight together with excessive levels of PA are characteristic for a subgroup of individuals with AN [2]. Since the SCOFF questionnaire itself does not allow for exact cross-sectional ED classification in adolescents at the moment, future research should perhaps focus on the development of a similar clinical algorithm as the recently developed Expali TM [45,46]. This can provide more comprehensive knowledge about prevalence rates of eating and other mental disorders, which is central to the provision of health care in the community [4].…”

Eating Disorders among College Students in France: Characteristics, Help-and Care-Seeking

“…Student participants filled in the French five-item “Sick, Control, One stone, Fat, Food” (SCOFF) questionnaire for ED screening [ 22 ]. A diagnostic threshold was fixed at two positive responses, with a sensitivity of 0.88 and a specificity of 0.93, using interviews as a diagnostic reference; therefore, data obtained with SCOFF gave a proxy of actual ED [ 23 ]. The Expali TM -validated algorithmic tool, combining SCOFF and body mass index, was used [ 21 ] to screen EDs into three diagnostic categories [ 24 ]: restrictive eating disorders, that is, anorexia nervosa, atypical anorexia nervosa, and restrictive food intake disorder; bulimic eating disorders, that is, bulimia nervosa and low-frequency/short-duration bulimia nervosa; and hyperphagic eating disorders, that is, binge-eating disorder and low-frequency/short-duration binge-eating disorder.…”

Nutritional education protocol in the treatment of eating disorders in the clinical and care settings

“…Consta de cinco preguntas dicotómicas (Sí/No) que valoran la pérdida de control sobre la ingesta, las purgas y la insatisfacción corporal (36). La versión en español esta validada como cuestionario de excelentes propiedades psicométricas para la detección de los TCA en la atención primaria, pudiendo utilizarse ampliamente en las poblaciones en riesgo (37).…”