Abstract
Reference [1] presented pooled data for the specificity of the M-FAST cut-off, but ignored or excluded data based on poor justifications and used questionable analytic methods. The analyses here corrected the problems associated with [1]. No moderator substantively influenced sensitivity values. Therefore, sensitivity values were pooled across all studies (k = 25) to provide an overall estimate. Overall, the average sensitivity of the M-FAST cut-off was estimated to be 0.87, 95% CI [0.80, 0.91], and 80% of true sensitivity values were estimated to range from 0.63 to 0.96. Thus, there could be methodological scenarios when the M-FAST cut-off may not operate efficiently. Average specificity values for the M-FAST cut-off were moderated by one variable: the comparison group. On average, specificity values for clinical comparison (k = 15) groups (i.e., 0.80, 95% CI [0.73, 0.85]) were lower than specificity values for non-clinical comparison (k = 11) groups (i.e., 0.96, 95% CI [0.89, 0.99]). Unlike the CIs, the estimated distributions of true specificity values for the two subgroups overlapped, which suggests there could be scenarios when these subgroups share the same true specificity value. The M-FAST was designed to be a screener to detect potential feigning of psychiatric symptoms. An examinee is never to be designating as feigning or malingering psychiatric symptoms based on only a positive M-FAST result. As a screening instrument, the results here show that the M-FAST cut-off is operating adequately overall and negate the conclusions of [1].
Highlights
Reference [1] concluded that the Miller Forensic Assessment of Symptoms Test (M-FAST; [2]) should no longer be used in practice
It was decided to examine whether the average sensitivity and specificity values among studies which used the Structured Interview of Reported Symptoms (SIRS) were substantively greater than the averages of such values for studies which did not use the SIRS to identify feigning groups. Since these analyses focused on designs which used other psychological measures to establish feigning groups, simulation designs were not included, and [25] was excluded because it was not a simulation design, partial criterion designs (PCDs), or known-groups comparisons (KGCs)
For the translated subgroup, the CrI was quite wide. This suggests that the specificity for the M-FAST cut-off could be low in some methodologies which employ a non-English M-FAST. These results provide some initial encouragement for the translation of the M-FAST, but the non-English subgroup was based on a heterogenous sample of languages and participants with different cultural backgrounds
Summary
Reference [1] concluded that the Miller Forensic Assessment of Symptoms Test (M-FAST; [2]) should no longer be used in practice. There is something unique to simulation designs which use M-FAST translations and clinical comparison groups because [11] and [24] were simulation designs whereas [10] and [21] were partial criterion designs (PCDs) Based on this type of design (i.e., no SIRS and clinical comparison group), [1]’s blanket conclusions regarding the M-FAST specificity are erroneous because the average estimates for the distribution of true specificity values as well as the CrIs demonstrate that the MFAST specificity values span into what may be viewed as acceptable for a screening instrument
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