Clinical indicators for routine use in the evaluation of early psychosis intervention: development, training support and inter-rater reliability.
Aim: Clinical practice improvement carried out in a quality assurance framework relies on routinely collected data using clinical indicators. Herein we describe the development, minimum training requirements, and inter-rater agreement of indicators that were used in an Australian multi-site evaluati...
| Publicado en: | Australian & New Zealand Journal of Psychiatry Vol. 45; no. 1; pp. 63 - 76 |
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| Autores principales: | , , , , , , , , , |
| Formato: | forms research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Jan2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104971284&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104971284 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00048674 7ZU jtl: Australian & New Zealand Journal of Psychiatry issn: 00048674 maglogo: Y pubinfo: dt: Jan2011 vid: 45 iid: 1 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 104971284 56593929 10.3109/00048674.2010.524621 NLM20977312 104971284 ppf: 63 ppct: 13 formats: fmt: @attributes: type: P tig: atl: Clinical indicators for routine use in the evaluation of early psychosis intervention: development, training support and inter-rater reliability. aug: au: Catts SV Frost ADJ O'Toole BI Carr VJ Lewin T Neil AL Harris MG Evans RW Crissman BR Eadie K affil: School of Medicine, University of Queensland, K Floor, Mental Health Centre, Royal Brisbane and Women's Hospital, Herston, Queensland 4029, Australia sug: subj: Clinical Indicators Schizophrenia Psychotic Disorders Suicide Risk Factors Risk Assessment Quality Improvement Methods New South Wales Vignettes Descriptive Statistics Interrater Reliability Male Female kappa Statistic Scales Questionnaires Program Evaluation Human Male Female ab: Aim: Clinical practice improvement carried out in a quality assurance framework relies on routinely collected data using clinical indicators. Herein we describe the development, minimum training requirements, and inter-rater agreement of indicators that were used in an Australian multi-site evaluation of the effectiveness of early psychosis (EP) teams. Methods: Surveys of clinician opinion and face-to-face consensus-building meetings were used to select and conceptually define indicators. Operationalization of definitions was achieved by iterative refinement until clinicians could be quickly trained to code indicators reliably. Calculation of percentage agreement with expert consensus coding was based on ratings of paper-based clinical vignettes embedded in a 2-h clinician training package. Results: Consensually agreed upon conceptual definitions for seven clinical indicators judged most relevant to evaluating EP teams were operationalized for ease-of-training. Brief training enabled typical clinicians to code indicators with acceptable percentage agreement (60% to 86%). For indicators of suicide risk, psychosocial function, and family functioning this level of agreement was only possible with less precise 'broad range' expert consensus scores. Estimated kappa values indicated fair to good inter-rater reliability (kappa > 0.65). Inspection of contingency tables (coding category by health service) and modal scores across services suggested consistent, unbiased coding across services. Conclusions: Clinicians are able to agree upon what information is essential to routinely evaluate clinical practice. Simple indicators of this information can be designed and coding rules can be reliably applied to written vignettes after brief training. The real world feasibility of the indicators remains to be tested in field trials. pubtype: Academic Journal doctype: forms research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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