Comparative accuracy of ICD-11 clinical descriptions and diagnostic requirements for the classification of mental and behavioral disorders: A systematic review and meta-analysis of case-controlled field studies

Case-controlled field studies have been conducted to evaluate the clinical utility of ICD-11 clinical descriptions and diagnostic requirements (ICD-11 CDDR) in the diagnosis of mental disorders, including analyses of diagnostic accuracy. The present systematic review and meta-analysis sought to evaluate the sensitivity (Se) of these guidelines compared with those of other diagnostic systems studied by mental health professionals (MHPs) from different regions of the world. A systematic search was conducted in four databases where relevant studies were subjected to explicit eligibility criteria, resulting in 10 included studies and 264 effect sizes. The study characteristics were tabulated, and the findings were synthesized through a series of random-effects meta-analyses. The overall findings indicated that the diagnostic accuracy of MHPs’ clinical judgments with the ICD-11 CDDR was significantly higher than that obtained with the ICD-10 Clinical Descriptions and Diagnostic Guidelines (ICD-10 CDDG) (Q = 17.35 ₍₁₎, p < 0.0001). Additional meta-analyses have revealed sources of variation, slight (non-significant) superiority of the ICD-11 CDDR for the diagnosis of mood disorders, and poor performance of all guidelines for the diagnosis of subclinical conditions. The superiority of diagnostic accuracy was supported for MHPs using ICD-11 CDDR. Future ecological implementation research should be able to evaluate these and other indices of clinical utility better. Finally, it is necessary to expand the scope of the training programs for the use of these guidelines in clinical practice.