The use of chance-corrected agreement to diagnose canine compulsive disorder: An approach to behavioral diagnosis in the absence of a 'gold standard'

This study assessed the diagnostic accuracy of formal diagnostic criteria f or canine compulsive disorder (canine CD). Canine CD is a syndrome of abnor mal behaviors that are believed to result from conflict or frustration. Dif ferential diagnoses include normal conflict behavior and learned behavior. In studies of canine CD, confidence in the diagnosis comes with knowing the accuracy of the diagnostic method. This accuracy may be quantified as the chance-corrected agreement between the diagnostic method and a 'gold standa rd' diagnostic test. The present study examined the agreement between diagn oses of canine CD made by an expert (the 'gold standard') and by using form al diagnostic criteria. The owners of 84 dogs suspected of having CD receiv ed 2 telephone interviews. The first utilized a detailed, pre-tested questi onnaire; a dog was then diagnosed with CD if the behavioral history met 7 d iagnostic criteria. The second interview was given by a behavioral expert w hose diagnosis was based on personal experience. The interviewers were blin d to each other's diagnoses. The chance-corrected agreement between diagnos es was minimal (kappa = 0.02) and disagreement was associated with 3 of the formal criteria: a history of conflict or frustration, an increase in the number of contexts that elicit the behavior, and an increase in the daily f requency of the behavior. Reasons for the disagreement include the order of the interviews, response biases, the setting of the interviews, and, possi bly, the diversity of the behaviors associated with canine CD. To the autho rs' knowledge, this type of study is the first in clinical ethology to addr ess validation of the diagnostic method. The results indicate 3 development al aspects of canine CD that should be examined in future work.