title: The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT): a new tool for the psychosocial evaluation of pre-transplant candidates.
abstract: BACKGROUND
  While medical criteria have been well established for each end-organ system, psychosocial listing criteria are less standardized. To address this limitation, we developed and tested a new assessment tool: the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT).
  
  
  METHODS
  The SIPAT was developed from a comprehensive review of the literature on the psychosocial factors that impact transplant outcomes. Five examiners blindly applied the SIPAT to 102 randomly selected transplant cases, including liver, heart, and lung patients. After all subject's files had been rated by the examiners, the respective transplant teams provided the research team with the patient's outcome data.
  
  
  RESULTS
  Univariate logistic regression models were fit in order to predict the transplant psychosocial outcome (positive or negative) using each rater's SIPAT scores. These results show that SIPAT scores are highly predictive of the transplant psychosocial outcome (P < 0.0001). The instrument has excellent inter-rater reliability (Pearson's correlation coefficient = 0.853), even among novice raters.
  
  
  CONCLUSIONS
  The SIPAT is a comprehensive screening tool to assist in the psychosocial assessment of organ transplant candidates. Its strengths includes the standardization of the evaluation process and its ability to identify subjects who are at risk for negative outcomes after the transplant, in order to allow for the development of interventions directed at improving the patient's candidacy. Our goal is that the SIPAT, in addition to a set of agreed upon minimal psychosocial listing criteria, would be used in combination with organ-specific medical listing criteria in order to establish standardized criteria for the selection of transplant recipients.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. jrm@stanford.edu
authors.forename: José R
authors.initials: JR
authors.lastname: Maldonado
authors.forename: Holly C
authors.initials: HC
authors.lastname: Dubois
authors.forename: Evonne E
authors.initials: EE
authors.lastname: David
authors.forename: Yelizaveta
authors.initials: Y
authors.lastname: Sher
authors.forename: Sermsak
authors.initials: S
authors.lastname: Lolak
authors.forename: Jameson
authors.initials: J
authors.lastname: Dyal
authors.forename: Daniela
authors.initials: D
authors.lastname: Witten
mesh_terms: D001294:Attitude to Health; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D016377:Organ Transplantation / Q000523:psychology*; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012196:Review Literature as Topic; D012307:Risk Factors; D012944:Social Support; D011795:Surveys and Questionnaires / Q000592:standards*; D016896:Treatment Outcome