Scientific background: Eating Habits

About this test

The SCOFF was developed in 1999 by Morgan, Reid, and Lacey in a British primary-care sample and published in the BMJ. In the original study, a threshold of two or more "yes" answers correctly identified roughly 85-100% of people with a diagnosed eating disorder (sensitivity), with similarly high specificity. SCOFF has since been translated into numerous languages and validated internationally. As a pure brief screen, it can produce false positives and false negatives and doesn't replace a thorough evaluation.

A systematic review and meta-analysis pooling 25 studies (2020) confirms this good detection accuracy holds up across many different samples: pooled sensitivity of 86% and specificity of 83%, with an overall discrimination (AUC) of 0.91 -- a value generally considered very good in diagnostic accuracy research. These pooled figures reflect a wider range of real-world settings than the original single-sample British study the SCOFF was first validated on.

Dimensions

Sources & license

• Morgan, J. F., Reid, F., & Lacey, J. H. (1999). The SCOFF questionnaire: Assessment of a new screening tool for eating disorders. BMJ, 319(7223), 1467–1468.

  The five SCOFF questions were published in full in the original article. No explicit open-access or reuse license statement could be verified on the article itself (it predates BMJ's modern open-access licensing) -- but the questions are ubiquitously reproduced verbatim with citation across health services, hospitals, and public-health screening toolkits worldwide as well-established clinical practice. Item wording was verified verbatim against the original BMJ article, including the original British "one stone" (~6.35 kg) unit in item 3.

• Kutz, A. M., Marsh, A. G., Gunderson, C. G., Maguen, S., & Masheb, R. M. (2020). Eating disorder screening: A systematic review and meta-analysis of diagnostic test characteristics of the SCOFF. Journal of General Internal Medicine, 35(3), 885–893.

  Scientific publication, cited as evidence for pooled diagnostic accuracy.