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• Because you can get specific by triggering screenings as indicated, you can check more domains of clinical information making the process more sensitive.
• In practice using the PHQ-2 and GAD-2 for example, you prescreen for both depression and anxiety with only four questions and trigger the full PHQ-9 or GAD-7 as necessary to get more specific.
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• Opening up the sensitivity you will create more false-positives, which you can largely remove by getting more specific, for example prescreens triggering full screenings
• Understanding that a screening measure can be both a condition as well as a symptom, triggering measures for comorbid or causal conditions, produces greater specificity while requiring less clinician follow up. For example depression can be just depression, associated with mania, locked by PTSD or implicated in substance abuse issues. You want to screen all these domains to get specific enough to sort out the level of care required.
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