Cross-National Reliability of Clinician-Rated Outcome Measures in Child and Adolescent Mental Health Services

Hanssen‐Bauer, Ketil; Gowers, Simon; Aalen, Odd O.; Bilenberg, Niels; Brann, Peter; Garralda, Elena; Merry, Sally; Heyerdahl, Sonja

doi:10.1007/s10488-007-0135-x

Cited by 39 publications

(43 citation statements)

References 20 publications

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“…Systematic rater bias could have contributed to this finding. However, we found moderate inter-rater reliability for the HoNOSCA total score among the clinicians that participated in this study, in agreement with another study of the inter-rater reliability of HoNOSCA in outpatient clinics [24] and with a cross-national study [25]. Lyons and McCulloch also found differences in outcome between child and adolescent in-patient units, and they recommended monitoring and comparing the outcomes of in-patient units to identify their strengths and weaknesses.…”

Section: Discussionsupporting

confidence: 92%

Admissions to acute adolescent psychiatric units: a prospective study of clinical severity and outcome

Hanssen‐Bauer

Heyerdahl

Hatling

et al. 2011

Int J Ment Health Syst

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BackgroundSeveral countries have established or are planning acute psychiatric in-patient services that accept around-the-clock emergency admission of adolescents. Our aim was to investigate the characteristics and clinical outcomes of a cohort of patients at four Norwegian units.MethodsWe used a prospective pre-post observational design. Four units implemented a clinician-rated outcome measure, the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), which measures mental health problems and their severity. We collected also data about the diagnoses, suicidal problems, family situations, and the involvement of the Child Protection Service. Predictions of outcome (change in HoNOSCA total score) were analysed with a regression model.ResultsThe sample comprised 192 adolescents admitted during one year (response rate 87%). Mean age was 15.7 years (range 10-18) and 70% were girls. Fifty-eight per cent had suicidal problems at intake and the mean intake HoNOSCA total score was 18.5 (SD 6.4). The largest groups of main diagnostic conditions were affective (28%) and externalizing (26%) disorders. Diagnoses and other patient characteristics at intake did not differ between units. Clinical psychiatric disorders and developmental disorders were associated with severity (on HoNOSCA) at intake but not with outcome. Of adolescents ≥ 16 years, 33% were compulsorily admitted. Median length of stay was 8.5 days and 75% of patients stayed less than a month. Compulsory admissions and length of stay varied between units. Mean change (improvement) in the HoNOSCA total score was 5.1 (SD 6.2), with considerable variation between units. Mean discharge score was close to the often-reported outpatient level, and self-injury and emotional symptoms were the most reduced symptoms during the stay. In a regression model, unit, high HoNOSCA total score at intake, or involvement of the Child Protection Service predicted improvement during admission.ConclusionsAcute psychiatric in-patient units for adolescents effectively meet important needs for young people with suicidal risks or other severe mental health problems. These units may act in suicide prevention, stabilizing symptom severity at a lower level within a short stay. It is important to explore the differences in outcome, compulsory admissions, and length of stay between units.

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Section: Discussionsupporting

confidence: 92%

Admissions to acute adolescent psychiatric units: a prospective study of clinical severity and outcome

Hanssen‐Bauer

Heyerdahl

Hatling

et al. 2011

Int J Ment Health Syst

Self Cite

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“…Differences between the MC/ICD-10 and DSM-IV are in general comparatively small (Cooper, 2003), although MC/ICD-10 has fewer investigations of its diagnostic categories (Fonseca & Perrin, 2001). Moderate to fair inter-reliability for axis VI was found among clinicians, within and across different countries (Dyrborg et al, 2000;Hanssen-Bauer et al, 2007). Table 4 Distribution of principal anxiety diagnoses in both samples.…”

Section: Methodsmentioning

confidence: 99%

Assessing child and adolescent anxiety in psychiatric samples with the Child Behavior Checklist

Pauschardt

Remschmidt

Mattejat

2010

Journal of Anxiety Disorders

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“…Instruction and training should be consistent with the procedures for administration used in developing the ClinRO assessment. This is especially important in multicenter and cross-national trials, in which implementation may differ across various sites [45–47]. Developers should plan and ensure adequate training of investigators and site staff to mitigate sources of variability and measurement error.…”

Section: Good Measurement Practicesmentioning

confidence: 99%

Clinician-Reported Outcome Assessments of Treatment Benefit: Report of the ISPOR Clinical Outcome Assessment Emerging Good Practices Task Force

et al. 2017

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A clinician-reported outcome (ClinRO) assessment is a type of clinical outcome assessment (COA). ClinRO assessments, like all COAs (patient-reported, observer-reported, or performance outcome assessments), are used to 1) measure patients’ health status and 2) define end points that can be interpreted as treatment benefits of medical interventions on how patients feel, function, or survive in clinical trials. Like other COAs, ClinRO assessments can be influenced by human choices, judgment, or motivation. A ClinRO assessment is conducted and reported by a trained health care professional and requires specialized professional training to evaluate the patient’s health status. This is the second of two reports by the ISPOR Clinical Outcomes Assessment—Emerging Good Practices for Outcomes Research Task Force. The first report provided an overview of COAs including definitions important for an understanding of COA measurement practices. This report focuses specifically on issues related to ClinRO assessments. In this report, we define three types of ClinRO assessments (readings, ratings, and clinician global assessments) and describe emerging good measurement practices in their development and evaluation. The good measurement practices include 1) defining the context of use; 2) identifying the concept of interest measured; 3) defining the intended treatment benefit on how patients feel, function, or survive reflected by the ClinRO assessment and evaluating the relationship between that intended treatment benefit and the concept of interest; 4) documenting content validity; 5) evaluating other measurement properties once content validity is established (including intra- and inter-rater reliability); 6) defining study objectives and end point(s) objectives, and defining study end points and placing study end points within the hierarchy of end points; 7) establishing interpretability in trial results; and 8) evaluating operational considerations for the implementation of ClinRO assessments used as end points in clinical trials. Applying good measurement practices to ClinRO assessment development and evaluation will lead to more efficient and accurate measurement of treatment effects. This is important beyond regulatory approval in that it provides evidence for the uptake of new interventions into clinical practice and provides justification to payers for reimbursement on the basis of the clearly demonstrated added value of the new intervention.

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Cross-National Reliability of Clinician-Rated Outcome Measures in Child and Adolescent Mental Health Services

Cited by 39 publications

References 20 publications

Admissions to acute adolescent psychiatric units: a prospective study of clinical severity and outcome

Admissions to acute adolescent psychiatric units: a prospective study of clinical severity and outcome

Assessing child and adolescent anxiety in psychiatric samples with the Child Behavior Checklist

Clinician-Reported Outcome Assessments of Treatment Benefit: Report of the ISPOR Clinical Outcome Assessment Emerging Good Practices Task Force

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