Original Article

Administration and Policy in Mental Health and Mental Health Services Research

, Volume 41, Issue 5, pp 647-659

Pitfalls in the Assessment, Analysis, and Interpretation of Routine Outcome Monitoring (ROM) Data: Results from an Outpatient Clinic for Integrative Mental Health

  • Rogier H. J. HoendersAffiliated withCenter for Integrative Psychiatry, Lentis
  • , Elisabeth H. BosAffiliated withInterdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen Email author 
  • , Agna A. Bartels-VelthuisAffiliated withCenter for Integrative Psychiatry, LentisUniversity Center for Psychiatry, University Medical Center Groningen, University of Groningen
  • , Nina K. VollbehrAffiliated withCenter for Integrative Psychiatry, Lentis
  • , Karen van der PloegAffiliated withCenter for Integrative Psychiatry, Lentis
  • , Peter de JongeAffiliated withInterdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen
  • , Joop T. V. M. de JongAffiliated withAmsterdam Institute for Social Science Research (AISSR), University of AmsterdamBoston School of MedicineRhodes University

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Abstract

There is considerable debate about routine outcome monitoring (ROM) for scientific or benchmarking purposes. We discuss pitfalls associated with the assessment, analysis, and interpretation of ROM data, using data of 376 patients. 206 patients (55 %) completed one or more follow-up measurements. Mixed-model analysis showed significant improvement in symptomatology, quality of life, and autonomy, and differential improvement for different subgroups. Effect sizes were small to large, depending on the outcome measure and subgroup. Subtle variations in analytic strategies influenced effect sizes substantially. We illustrate how problems inherent to design and analysis of ROM data prevent drawing conclusions about (comparative) treatment effectiveness.

Keywords

Routine outcome monitoring Treatment outcome Integrative psychiatry Bias Confounding