Rating the raters: assessing the quality of Hamilton rating scale for depression clinical interviews in two industry-sponsored clinical drug trials.
OBJECTIVE
The quality of clinical interviews conducted in industry-sponsored clinical drug trials is an important but frequently overlooked variable that may influence the outcome of a study. We evaluated the quality of Hamilton Rating Scale for Depression (HAM-D) clinical interviews performed at baseline in 2 similar multicenter, randomized, placebo-controlled depression trials sponsored by 2 pharmaceutical companies.


METHODS
A total of 104 audiotaped HAM-D clinical interviews were evaluated by a blinded expert reviewer for interview quality using the Rater Applied Performance Scale (RAPS). The RAPS assesses adherence to a structured interview guide, clarification of and follow-up to patient responses, neutrality, rapport, and adequacy of information obtained.


RESULTS
HAM-D interviews were brief and cursory and the quality of interviews was below what would be expected in a clinical drug trial. Thirty-nine percent of the interviews were conducted in 10 minutes or less, and most interviews were rated fair or unsatisfactory on most RAPS dimensions.


CONCLUSIONS
Results from our small sample illustrate that the clinical interview skills of raters who administered the HAM-D were below what many would consider acceptable. Evaluation and training of clinical interview skills should be considered as part of a rater training program.
Engelhardt
Nina
N
MedAvante, Inc. MedAvante, Ewing, NJ, USA. ne@medavante.net
Feiger
Alan D
AD
Cogger
Kenneth O
KO
Sikich
Dawn
D
DeBrota
David J
DJ
Lipsitz
Joshua D
JD
Kobak
Kenneth A
KA
Evans
Kenneth R
KR
Potter
William Z
WZ
D000928:Antidepressive Agents / Q000627:therapeutic use; D003863:Depression / Q000188:drug therapy; D004345:Drug Industry; D019983:Guideline Adherence; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D017410:Practice Guidelines as Topic; D011361:Professional Competence; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D012108:Research Personnel / Q000193:education*; D013997:Time Factors
D000928:Antidepressive Agents