The empirical evidence base for the use of the HCR-20: A narrative review of study designs and transferability of results to clinical practice.

Autor: Challinor A; University of Liverpool, UK; Health Education England North West, Liverpool, UK; Mersey Care NHS Foundation Trust, UK. Electronic address: alex.challinor1@nhs.net., Ogundalu A; Cheshire and Wirral Partnership NHS Trust, UK., McIntyre JC; John Moores University Liverpool, UK., Bramwell V; Cheshire and Wirral Partnership NHS Trust, UK., Nathan R; Cheshire and Wirral Partnership NHS Trust, UK; University of Liverpool, UK; University of Chester, UK; John Moores University Liverpool, UK.
Jazyk: angličtina
Zdroj: International journal of law and psychiatry [Int J Law Psychiatry] 2021 Sep-Oct; Vol. 78, pp. 101729. Date of Electronic Publication: 2021 Aug 20.
DOI: 10.1016/j.ijlp.2021.101729
Abstrakt: The HCR-20, a widely used method of assessing and managing risk, relies on the structured professional judgement approach. This paper reports a narrative literature review of the HCR-20 studies to explore the applicability of the study results to the use of the HCR-20 in clinical practice. From a literature search using terms "HCR-20" and "HCR 20", 206 papers were included. Of studies using the HCR-20 version 2 (n = 191), 92% (n = 176) relied on variables based on scores derived by adding item scores, and 50% (n = 95) tested the HCR-20 using predictive validity methodology. Of the HCR-20 version 3 studies (n = 21), the "presence of risk factors" step was the most commonly examined (n = 18, 86%), but 2 of the 7 steps ("scenario planning" and "management") were not examined at all. Amongst those studies whose primary focus was on the HCR-20, 67% (n = 64/95) did so by assessing the predictive validity of the tool. Only one employed a design to test whether the use of the HCR-20 affected violence rates. The predominant study design provides support for the use of the HCR-20 as an actuarial tool, and there is limited empirical evidence in support of its effectiveness as a structured professional judgement approach to the assessment and management of the risk of violence.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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