title: Classification of risk in psychiatry.
abstract: Psychiatric risk-assessments generally quantify risk using broad, categorical, indicators (e.g., high-risk, low-risk). We examined reliability of such indicators when applied by mental-health professionals. Four versions of a questionnaire were used, each specifying a different clinical outcome along with a range of different probabilities at which that outcome might occur. Respondents classified each probability, allowing a comparison of the level of likelihood at which different professionals would apply the terms 'high-risk', 'medium-risk' and 'low-risk'. We found little consistency among professionals who assessed risk for the same outcomes. Moreover, there were also large and unpredicted differences in response-profiles between the 4 clinical outcomes. These findings raise concerns about the communication value of current risk-assessment terminology.
authors: Department of Psychiatry, QEII Hospital, Howlands, Welwyn-Garden-City, Herts, AL7 4HL, UK. t.gale@herts.ac.uk
authors: Tim M
authors: TM
authors: Gale
authors: Chris J
authors: CJ
authors: Hawley
authors: Thanusha
authors: T
authors: Sivakumaran
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification*; D008875:Middle Aged; D011570:Psychiatry / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012306:Risk; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D055815:Young Adult