title: Routine evaluation of mental health: reliable information or worthless "guesstimates'?
abstract: Routine evaluation of mental health care systems necessitates a quick assessment of progress and outcome. This study was designed to determine the value of the GAF-scale in such applications. We allowed 104 raters from six therapeutic centres to rate five clinical case-vignettes. Interrater reliability was almost equal for raters within different professional categories. The highest and the lowest scores for each of the case-vignettes differed by between 39 and 45 points. The raters' biases ranged from -23 to +30 points, and random deviations were between 1 and 20 points. Systematic differences between centres were up to 6 points. Our main finding is that the reliability of GAF scores in routine settings proved unsatisfactory with entrained raters.
authors.affiliation: Department of Clinical Psychiatric Research, Ullevaal University Hospital, Oslo, Norway.
authors.forename: H
authors.initials: H
authors.lastname: Loevdahl
authors.forename: S
authors.initials: S
authors.lastname: Friis
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D009664:Norway; D015588:Observer Variation; D010348:Patient Care Team; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics; D015203:Reproducibility of Results