Comparing Methods to Denote Treatment Outcome in Clinical Research and Benchmarking Mental Health Care

Beurs, Edwin de; Barendregt, Marko; Heer, Arco de; Duijn, Erik van; Goeree, Bob; Kloos, Margot; Kooiman, Kees; Lionarons, Helen; Merks, A.

doi:10.1002/cpp.1954

Cited by 27 publications

(35 citation statements)

References 35 publications

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“…Posttreatment scores and ΔT were corrected for case mix differences. The continuous nature of the T-scale optimizes statistical power and simplifies ranking of MHS providers (de Beurs et al 2016). However, a limitation of ΔT is that it produces a rather abstract figure, which does not yield any information on quality and nature of a patient’s clinical end state.…”

Section: Methodsmentioning

confidence: 99%

“…For JT RCI it should be unlikely ( p < .05) that change as expressed in the difference between the pre- and post-test score is due to measurement imprecision. For the JT RCI a value of ΔΤ = 5.0 is used that represents half a standard deviation and is considered the minimal clinically important difference (de Beurs et al 2016; Norman et al 2003; Sloan et al 2005). Patients with a case mix corrected ΔT > 5 were considered improved.…”

Section: Methodsmentioning

confidence: 99%

“…To meet clinical significant outcome or recovered status a patient’s score needs to be changed within the criteria of the reliable change index (JT RCI ), but also the posttreatment score needs to be within the functional range (JT CS ). For JT CS a cutoff point of T = 42.5 was determined (de Beurs et al 2016). Combined with case mix correction, for JT RCI&CS the case mix corrected posttreatment score needs to be T < 42.5 as well as more than five points less than the pretreatment T-score.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Treatment Outcome, Duration, and Costs: A Comparison of Performance Indicators Using Data from Eight Mental Health Care Providers in The Netherlands

Beurs

Warmerdam

Oudejans³

et al. 2017

Adm Policy Ment Health

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Assessing performance of mental health services (MHS) providers merely by their outcomes is insufficient. Process factors, such as treatment cost or duration, should also be considered in a meaningful and thorough analysis of quality of care. The present study aims to examine various performance indicators based on treatment outcome and two process factors: duration and cost of treatment. Data of patients with depression or anxiety from eight Dutch MHS providers were used. Treatment outcome was operationalized as case mix corrected pre-to-posttreatment change scores and as reliable change (improved) and clinical significant change (recovered). Duration and cost were corrected for case mix differences as well. Three performance indicators were calculated and compared: outcome as such, duration per outcome, and cost per outcome. The results showed that performance indicators, which also take process variability into account, reveal larger differences between MHS providers than mere outcome. We recommend to use the three performance indicators in a complementary way. Average pre-to-posttreatment change allows for a simple and straightforward ranking of MHS providers. Duration per outcome informs patients on how MHS providers compare in how quickly symptomatic relief is achieved. Cost per outcome informs MHS providers on how they compare regarding the efficiency of their care. The substantial variation among MHS providers in outcome, treatment duration and cost calls for further exploration of its causes, dissemination of best practices, and continuous quality improvement.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Treatment Outcome, Duration, and Costs: A Comparison of Performance Indicators Using Data from Eight Mental Health Care Providers in The Netherlands

Beurs

Warmerdam

Oudejans³

et al. 2017

Adm Policy Ment Health

View full text Add to dashboard Cite

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“…The discussion on external benchmarking with ROM is further complicated by concerns about the privacy of patient data and the restriction that only pre-post treatment ROM data are used. For more discussion on external benchmarking with ROM, we refer to some relevant publications [44][45][46][47][48][49].…”

Section: Routine Outcome Monitoringmentioning

confidence: 99%

Routine Outcome Monitoring in Mental Health Care and Particularly in Addiction Treatment: Evidence-Based Clinical and Research Recommendations

Carlier¹,

Eeden²

2017

J Addict Res Ther

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Routine Outcome Monitoring (ROM) concerns the repeated measurement of the progress of a patient's treatment during the course of therapy. ROM is receiving mounting attention as an important quality tool, and because of increased emphasis on health care accountability and cost containment. ROM seems especially relevant for complicated chronic patients that require a long-term treatment. Although addictive patients often have these clinical characteristics, ROM is relatively less investigated within addiction treatment. The present article summarizes recent state-of-the-art information concerning the use of ROM in mental health care and particularly in addiction treatment. First, some basics about ROM in general are described. Next, evidence for the effectiveness of ROM in mental health care and addiction treatment is reviewed. Finally, some clinical & research recommendations are suggested for the use of ROM in addiction treatment.

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“…As an example, the Netherlands have built a nationwide infrastructure to collect of patient-reported data to organize mental health care. Annually, 50% of 1,000,000 treatments performed yearly in the Dutch mental health care have complete outcome data on patients that can be evaluated [19] . This data includes assessment of symptomology and functioning in patients at regular intervals.…”

Section: Applied Patient-centred Outcome Funding Allocationmentioning

confidence: 99%

The problem of patient-centred outcome measurement in psychiatry: why metrology hasn’t mattered and why it should

Barbic

Cano²,

Mathias

2018

J. Phys.: Conf. Ser.

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Abstract. In psychiatry, there is a call for clinicians to use patient-centred outcome data routinely at the point of care to help tailor treatment plans to meet patient preferences and needs. Given that many decisions in psychiatry are constructed from patient narratives, it is critical that the conceptual, empirical, and measurement structure underlying patient reported outcome measures is robust and patient-centred. Here, we argue for the systematic accruement of patient-centred data in psychiatry to meaningfully enhance the treatment of mental disorders. Specifically, we suggest three crucial considerations for system transformation: (1) the engagement of international patient research partners to conceptualize and prioritize outcomes; (2) the application of modern test theory to develop and evaluate patient-centred outcome measures; and (3) funding allocation accountable to evidence-based services prioritized by patients.

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Comparing Methods to Denote Treatment Outcome in Clinical Research and Benchmarking Mental Health Care

Cited by 27 publications

References 35 publications

Treatment Outcome, Duration, and Costs: A Comparison of Performance Indicators Using Data from Eight Mental Health Care Providers in The Netherlands

Treatment Outcome, Duration, and Costs: A Comparison of Performance Indicators Using Data from Eight Mental Health Care Providers in The Netherlands

Routine Outcome Monitoring in Mental Health Care and Particularly in Addiction Treatment: Evidence-Based Clinical and Research Recommendations

The problem of patient-centred outcome measurement in psychiatry: why metrology hasn’t mattered and why it should

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