Cross-National Reliability of Clinician-Rated Outcome Measures in Child and Adolescent Mental Health Services
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Clinician-rated measures are in extensive use as routine outcome measures in child and adolescent mental health services. We investigated cross-national differences and inter-rater reliability of the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), the Children’s Global Assessment Scale (CGAS) and the Global Assessment of Psychosocial Disability (GAPD). Thirty clinicians from 5 nations independently rated 20 written vignettes. The national groups afterwards established national consensus ratings. There were no cross-national differences in independent scores, but there were differences in national consensus scores, which were also more severe than independent scores. The ICC for the HoNOSCA total score was 0.84, for the CGAS 0.61 and for the GAPD 0.54. These measures may usefully contribute to cross-national comparison studies.
KeywordsChildren Adolescent Mental health Services Reliability Outcome
Thanks to the raters who rated the vignettes and discussed the ratings until consensus was achieved: Peter Birleson, Jens Buchhave, Tania Cargo, Merrie Carling, Tim Coombs, Per-Erik Davidsen, Heather Mc Dowell, Berit Groholt, Kirsten Hoerder, Jenny Hoffman, Timothy Hughes, Torben Isager, Craig Johnston, Margaret Jones, Sarah Laing, Flemming Warborg Larsen, Michael Maagensen, Torunn S Novik, Epenesa Olo-Whaanga, Andy Parkin, Peter Roots, Benedicte Skirbekk, Su Sukamaran and Sue Treanor. The study was supported by The Research Council of Norway and by Centre for Child and Adolescent Mental Health, Eastern and Southern Norway. Disclosure: The authors report no conflicts of interests.
- Becker, T., Knapp, M., Knudsen, H. C., Schene, A., Tansella, M., Thornicroft, G., et al. (1999). The EPSILON study of schizophrenia in five European countries. Design and methodology for standardising outcome measures and comparing patterns of care and service costs. British Journal of Psychiatry, 175, 514–521.PubMedGoogle Scholar
- Canino, G., & Bravo, M. (1999). The translation and adaptation of diagnostic instruments for cross-cultural use. In D. Shaffer, C. P. Lucas, & J. E. Richters (Eds.), Diagnostic assessment in child and adolescent psychopathology (pp. 285–298). New York: The Guilford Press.Google Scholar
- Department of Health and Ageing (2003). Mental health national outcomes and casemix collection: Technical specification of state and territory reporting requirements for the outcomes and casemix components of ‘agreed data’, Version 1.50. Canberra, Australia: Commonwealth Government.Google Scholar
- Dyrborg, J., Larsen, F. W., Nielsen, S., Byman, J., Nielsen, B. B., & Gautre-Delay, F. (2000). The Children’s Global Assessment Scale (CGAS) and Global Assessment of Psychosocial Disability (GAPD) in clinical practice - substance and reliability as judged by intraclass correlations. European Child & Adolescent Psychiatry, 9(3), 195–201.CrossRefGoogle Scholar
- Efron, B., & Tibshirani, R. J. (1993). An introduction to the Bootstrap. Chapman & Hall.Google Scholar
- Gowers, S. G., Harrington, R. C., Whitton, A., Lelliott, P., Beevor, A., Wing, J., et al. (1999). Brief scale for measuring the outcomes of emotional and behavioural disorders in children. Health of the Nation Outcome Scales for children and Adolescents (HoNOSCA). British Journal of Psychiatry, 174, 413–416.PubMedGoogle Scholar
- MH-SMART (15.2.2007). The Mental Health Standard Measures of Assessment and Recovery Summary. http://www.tepou.co.nz/page/tepou_11.php. Access date 19.3.2007.
- World Health Organization (1996). Multiaxial classification of child and adolescent psychiatric disorders. Cambridge University Press.Google Scholar