Approaches to denote treatment outcome: Clinical significance and clinical global impression compared

Autor:	Edwin de Beurs, Ingrid V. E. Carlier, Albert M. van Hemert
Jazyk:	angličtina
Rok vydání:	2019
Předmět:	Adult Male Psychometrics clinical significance Concurrent validity Outcome (game theory) Reliable Change Index 03 medical and health sciences 0302 clinical medicine Outcome Assessment Health Care Humans Clinical significance Association (psychology) Categorical variable Psychiatric Status Rating Scales Mental Disorders Original Articles Middle Aged humanities 030227 psychiatry Psychiatry and Mental health Categorization Convergent validity Clinical Global Impression treatment outcome Original Article Female Psychology 030217 neurology & neurosurgery clinical global impression Clinical psychology
Zdroj:	International Journal of Methods in Psychiatric Research International Journal of Methods in Psychiatric Research, 28(4), e1797 International Journal of Methods in Psychiatric Research, 28(4). WILEY
ISSN:	1557-0657 1049-8931
Popis:	ObjectivesThe authors of a previous study proposed a statistically based approach to denote treatment outcome, translating pretest and posttest scores into clinically relevant categories, such as recovery and reliable improvement. We assessed the convergent validity of the Jacobson–Truax (JT) approach, using T‐score based cutoff values, with ratings by an independent evaluator.MethodsPretest and retest scores on the Brief Symptom Inventory (BSI) and clinical global impression improvement (CGI‐I) ratings were collected repeatedly through routine outcome monitoring from 5,900 outpatients with common mental disorders. Data were collected in everyday practice in a large mental health care provider.ResultsContinuous pretest‐to‐retest BSI change scores had a stronger association with CGI‐I than the categorical variable based on JT. However, JT categorization and improvement according to CGI converged substantially with association indices (Somers' D) ranging from D = .50 to .56. Discordance was predominantly due to a more positive outcome according to JT than on CGI‐I ratings.ConclusionConverting continuous outcome variables into clinically meaningful categories comes at the price of somewhat diminished concurrent validity with CGI‐I. Nevertheless, support was found for the proposed threshold values for reliable change and recovery, and the outcome denoted in these terms corresponded with CGI improvement for most patients.
Databáze:	OpenAIRE
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