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

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.

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Fig. 1

Notes

  1. In practice ROM measurements are not always completed at the intended moment; for example because the discharge of a patient is not reported timely to the ROM staff member or a respondent is slow in his or her response

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Acknowledgments

The authors thank H. Berkelmans, R. Maring, P. Vellinga, M. Hoogeveen and S. Broekema for their assistance in collecting the data, and M. Appelo for his advice in the choice of design and questionnaires.

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Correspondence to Elisabeth H. Bos.

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Hoenders, R.H.J., Bos, E.H., Bartels-Velthuis, A.A. et al. Pitfalls in the Assessment, Analysis, and Interpretation of Routine Outcome Monitoring (ROM) Data: Results from an Outpatient Clinic for Integrative Mental Health. Adm Policy Ment Health 41, 647–659 (2014). https://doi.org/10.1007/s10488-013-0511-7

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  • DOI: https://doi.org/10.1007/s10488-013-0511-7

Keywords

  • Routine outcome monitoring
  • Treatment outcome
  • Integrative psychiatry
  • Bias
  • Confounding