The Study of Diagnostic Value of Bipolarity Index for Bipolar Disorder in China: Meta-analysis of Sensitivity and Specificity.

Objective: Bipolarity index (BI) is one of the diagnostic scales that assist the diagnosis of bipolar disorder (BD), and should be analyzed comprehensively for use in China.

Methods: We searched the Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), WANFANG, and Chinese Social Sciences Citation Index (CSSCI) in Chinese to find literature from July 31, 2004 to July 31, 2020, for results related to BI in the diagnosis for bipolar disorder (BD), among which results such as comments, letters, reviews, and case reports were excluded. The rates of sensitivity, specificity, accuracy, positive predictive value, and negative predictive value in diagnosis were synthesized and discussed.A total of 1237 patients were included in 5 studies. The criteria used for their selection were an anlysis of their results on the BI, and the diagnostic indexes of BI for BD in China.Thesensitivity, specificity, positive predictive value, negative predictive value, and accuracy of BI for BD in China were summarized in every study.Results: A total of 1237 subjects were included in 5 studies. The random effect model was used to account for the data with RevMan 5.2. The results showed that the diagnostic sensitivity of BI was 0.93 (95% CI: 0.93-1.00), and the specificity was 85% (95% CI: 0.69-0.96). The positive predictive value (PPV)was 74% (95% CI: 0.53-0.91). The negative predictive value (NPV) was 95% (95% CI: 0.81-1.00), and accuracy was 86% (95% CI: 0.77-0.93). Significant heterogeneity was detected across studies regarding these incidence estimates.Conclusion: The ideal diagnostic value of BI was found, although the studies showed significant heterogeneity. The results must be cautiously and attentively interpreted, in comparison to other diagnostic scales, to perfect the use of BI in clinical psychiatry.