Comparison of self-report and clinician-rated measures of psychiatric symptoms and functioning in predicting 1-year hospital readmission.
This study compared the self-report Behavior and Symptom Identification Scale (BASIS-32) and clinician-rated Global Assessment of Functioning (GAF) in their ability to predict a measure of psychiatric outcome, 1-year psychiatric hospital readmission. BASIS-32 and GAF were completed at admission for 1034 patients in an inpatient psychiatric facility. Multiple informants analysis was used to determine the difference between the two in predicting readmission within 1 year. We also examined sensitivity, specificity, and predictive value positive of the two measures, and whether self-report added information above clinician rating in predicting outcome. While the odds of 1-year readmission decreased with increasing BASIS-32 score, there was no association between change in GAF score and 1-year readmission. Although neither measure used alone demonstrated high predictive value, using both scores improved predictive ability over using clinician rating alone. In this setting, self-report was better than clinician rating in predicting psychiatric outcome. Differences between the two in relation to other outcomes need to be examined.
Clements
Karen M
KM
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. karen.clements@state.ma.us
Murphy
Jane M
JM
Eisen
Susan V
SV
Normand
Sharon-Lise T
SL
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008485:Medical Audit; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D010359:Patient Readmission / Q000639:trends*; D012189:Retrospective Studies; D012650:Self Disclosure