Interpreting Rule-Out Performance of Anxiety Screening Tools in Primary Care

Primary care clinicians frequently rely on brief screening instruments to assess patients with possible mood or anxiety disorders. When the clinical objective is to rule out disease, negative likelihood ratios (NLRs) provide the most useful measure of a tool’s ability to lower post-test probability after a negative result. An NLR < 0.1 is generally considered strong evidence for ruling out a condition. Which commonly used screening instrument meaningfully reduces the likelihood of an anxiety disorder when the result is negative?

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