Global perspectives on the Sleep Condition Indicator for DSM-5 insomnia disorder: a COSMIN and STARD systematic review of psychometric and diagnostic performance.
Level 1 - systematic review of randomized trials
Systematic review of diagnostic accuracy and psychometric validation studies
PubMed 41063190 · doi:10.1186/s12916-025-04285-7
What was done
Authors conducted a systematic review searching PubMed, EMBASE, CINAHL, MEDLINE, and citation indices from 2012 to 2024 for studies evaluating the translation, validation, and application of the Sleep Condition Indicator (SCI), a DSM-5-based insomnia screening tool. Measurement properties and methodological quality were evaluated using COSMIN guidelines, and diagnostic accuracy was assessed using STARD guidelines.
What was found
A total of 285 studies with over 720,000 participants across at least 31 regions were included, covering 13 language versions. In 19 psychometric studies, the tool demonstrated a stable two-factor structure, internal consistency, criterion validity, and reliability. In 14 diagnostic performance studies, the SCI showed adequate sensitivity and specificity, with a recommended cut-off score of 16 for insomnia screening. Specific quantitative diagnostic metrics (exact sensitivity, specificity, area under the curve) were not reported in the abstract.
Why it matters
This review synthesizes global validation data confirming the SCI as a reliable, standardized tool for screening and assessing DSM-5 insomnia disorder across research and clinical settings.
Limits
The abstract omits numerical values for diagnostic accuracy metrics such as sensitivity, specificity, and likelihood ratios. Detailed assessments of study-level risk of bias and heterogeneity across the 13 translated versions are not provided in the abstract.
Cited by
- supports Clinical insomnia is defined by difficulty initiating, maintaining sleep, or waking early at least three nights per week for at least three months, accompanied by distress.