title: Comparison of self-report and clinician-rated measures of psychiatric symptoms and functioning in predicting 1-year hospital readmission.
abstract: 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.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. karen.clements@state.ma.us
authors.forename: Karen M
authors.initials: KM
authors.lastname: Clements
authors.forename: Jane M
authors.initials: JM
authors.lastname: Murphy
authors.forename: Susan V
authors.initials: SV
authors.lastname: Eisen
authors.forename: Sharon-Lise T
authors.initials: SL
authors.lastname: Normand
mesh_terms: 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