Developing a decision tool to identify patients with personality disorders in need of highly specialized care
| Autor: | E. M. C. Willemsen, M. J. Noomx, C.M. van der Feltz-Cornelis, C.A. Uyl-de Groot, L. Hakkaart-van Roijen, Jan J. V. Busschbach, Maartje Goorden, Clazien A. M. Bouwmans-Frijters |
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| Přispěvatelé: | Health Technology Assessment (HTA), Psychiatry, Forensic Child and Youth Care (RICDE, FMG), Geestelijke Gezondheidszorg, Tranzo, Scientific center for care and wellbeing |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Decision tool Validation study medicine.medical_specialty Referral lcsh:RC435-571 media_common.quotation_subject Sensitivity and Specificity Decision Support Techniques 03 medical and health sciences 0302 clinical medicine lcsh:Psychiatry Medicine Personality Humans Medical physics 030212 general & internal medicine Highly specialized care Personality disorders media_common Receiver operating characteristic business.industry Concept map Multilevel model Reproducibility of Results medicine.disease 030227 psychiatry 3. Good health Psychiatry and Mental health Early Diagnosis ROC Curve Female business Clinical psychology Research Article |
| Zdroj: | BMC Psychiatry, Vol 17, Iss 1, Pp 1-13 (2017) BMC Psychiatry, 17:317. BioMed Central Ltd. BMC Psychiatry, 17:317. BioMed Central BMC Psychiatry |
| ISSN: | 1471-244X |
| DOI: | 10.1186/s12888-017-1460-6 |
| Popis: | Background Current guidelines recommend referral to highly specialized care for patients with severe personality disorders. However, criteria for allocation to highly specialized care are not clearly defined. The aim of the present study was to develop a decision tool that can support clinicians to identify patients with a personality disorder in need of highly specialized care. Methods Steps taken to develop a decision tool were a literature search, concept mapping, a meeting with experts and a validation study. Results The concept mapping method resulted in six criteria for the decision tool. The model used in concept mapping provided a good fit (stress value = 0.30) and reasonable reliability (ρ = 0.49). The bridging values were low, indicating homogeneity. The decision tool was subsequently validated by enrolling 368 patients from seven centers. A multilevel model with a Receiver Operating Characteristic Curve (ROC) was applied. In this way, an easily implementable decision tool with relatively high sensitivity (0.74) and specificity (0.69) was developed. Conclusions A decision tool to identify patients with personality disorders for highly specialized care was developed using advanced methods to combine the input of experts with currently available scientific knowledge. The tool appeared to be able to accurately identify this group of patients. Clinicians can use this decision tool to identify patients who are in need of highly specialized treatment. Electronic supplementary material The online version of this article (doi:10.1186/s12888-017-1460-6) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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