TPC-Journal-V6-Issue2

The Professional Counselor /Volume 6, Issue 2 129 Figure 3. ROC Curve for SYM, OAT and SAT t Scores Plotted Against Counselor SUD Diagnosis The ROC analysis of the OAT scale produced an AUROC value of .717, p = .000, standard error = .038, with a 95% confidence interval range of .643 to .791 (Figure 3). This indicates that there is fair agreement between the OAT scale and the counselors’ SUD diagnoses (Youngstrom, 2014). It was not possible to adjust the OAT t score to produce an optimal cut-off score such that a balance between sensitivity and specificity could be obtained. For example, to attain a sensitivity rating of .82, the t score cut-off would have to be lowered to 48.5, which would produce a specificity rating of .634. The ROC analysis of the SAT scale produced an AUROC value of .654, p = .001, standard error = .037, with a 95% confidence interval range of .582 to .727 (Figure 3). This indicates that there is poor agreement between the SAT scale and the counselors’ SUD diagnoses (Youngstrom, 2014). As with the OAT scale, no cut-off score could be determined that would provide an optimal balance between sensitivity and specificity. The SASSI-3’s overall decision was recalculated using the lowered Rule 1 and Rule 3 cut scores. This process resulted in a total of 188 persons being classified as likely dependent on the SASSI-3, or a change in the total number of classifications by 28. A follow-up analysis comparing the SASSI-3 final decision using the adjusted scores for Rules 1 and 3 and the original cut scores for Rules 2 and 4–9 with the counselors’ decisions produced a kappa of .457 ( p = .000). This kappa is slightly higher Note. Diagonal segments are produced by ties. t score t score t score