Use of a structured functional evaluation process for independent medical evaluations of claimants presenting with disabling mental illness: rationale and design for a multi-center reliability study
| Autor: | Nicole Vogel, J Jeger, Katrin Fischer, Jason W. Busse, Ulrike Hoffmann-Richter, Andrea Leibold, Heinz J. Schaad, Wout de Boer, R Marelli, Monica Bachmann, Ralph Mager, Regina Kunz, Oskar Bänziger, Thomas Zumbrunn, Stefan Schandelmaier |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Disability evaluation (MeSH)
related MeSH-term: reproducibility of results) medicine.medical_specialty Work Capacity Evaluation Functional approach Psychiatry (MeSH) Independent Medical Evaluation International Classification of Functioning 03 medical and health sciences Study Protocol Work capacity evaluation (MeSH) 0302 clinical medicine International Classification of Functioning Disability and Health Disability benefits medicine Humans 030212 general & internal medicine Psychiatry Reliability (statistics) Evidence-based medicine (MeSH) business.industry Mental Disorders Reliability (not MeSH Reproducibility of Results Insurance Medicine (not MeSH) Mental illness medicine.disease Mental disorders (MeSH) 3. Good health Psychological evaluation Psychiatry and Mental health Research Design Structured interview Insurance Disability Disability insurance (MeSH) Disability and Health business 030217 neurology & neurosurgery |
| Zdroj: | BMC Psychiatry BMC psychiatry |
| ISSN: | 1471-244X |
| Popis: | Background Work capacity evaluations by independent medical experts are widely used to inform insurers whether injured or ill workers are capable of engaging in competitive employment. In many countries, evaluation processes lack a clearly structured approach, standardized instruments, and an explicit focus on claimants’ functional abilities. Evaluation of subjective complaints, such as mental illness, present additional challenges in the determination of work capacity. We have therefore developed a process for functional evaluation of claimants with mental disorders which complements usual psychiatric evaluation. Here we report the design of a study to measure the reliability of our approach in determining work capacity among patients with mental illness applying for disability benefits. Methods/Design We will conduct a multi-center reliability study, in which 20 psychiatrists trained in our functional evaluation process will assess 30 claimants presenting with mental illness for eligibility to receive disability benefits [Reliability of Functional Evaluation in Psychiatry, RELY-study]. The functional evaluation process entails a five-step structured interview and a reporting instrument (Instrument of Functional Assessment in Psychiatry [IFAP]) to document the severity of work-related functional limitations. We will videotape all evaluations which will be viewed by three psychiatrists who will independently rate claimants’ functional limitations. Our primary outcome measure is the evaluation of claimant’s work capacity as a percentage (0 to 100 %), and our secondary outcomes are the 12 mental functions and 13 functional capacities assessed by the IFAP-instrument. Inter-rater reliability of four psychiatric experts will be explored using multilevel models to estimate the intraclass correlation coefficient (ICC). Additional analyses include subgroups according to mental disorder, the typicality of claimants, and claimant perceived fairness of the assessment process. Discussion We hypothesize that a structured functional approach will show moderate reliability (ICC ≥ 0.6) of psychiatric evaluation of work capacity. Enrollment of actual claimants with mental disorders referred for evaluation by disability/accident insurers will increase the external validity of our findings. Finding moderate levels of reliability, we will continue with a randomized trial to test the reliability of a structured functional approach versus evaluation-as-usual. |
| Databáze: | OpenAIRE |
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