title: Can standardized diagnostic assessment be a useful adjunct to clinical assessment in child mental health services? A randomized controlled trial of disclosure of the Development and Well-Being Assessment to practitioners.
abstract: OBJECTIVE
  While research demands standardized diagnostic assessments as an indication of sufficient methodological rigour, there is debate about their application to clinical practice. The Development and Well-Being Assessment (DAWBA) provides a structured assessment of psychiatric disorder. Since it can be completed on-line, it could be used by Child and Adolescent Mental Health Services with few additional demands on staff. Access to the standardized diagnostic information as an adjunct to clinical assessment could reduce the number of appointments spent on assessment, free up practitioner time to work on engagement and improve clinical outcomes by increasing the accuracy of assessment and thus access to the appropriate evidence-based treatment.
  
  
  METHODS
  Randomized controlled trial of the disclosure of the DAWBA to the assessing practitioner (n = 117) versus assessment at normal (n = 118) and analysed by "intention to disclose".
  
  
  RESULTS
  Exposure to the DAWBA may increase agreement between the DAWBA and practitioners about some anxiety disorders, but detected no other statistically significant increased agreement for other disorders, nor a reduced need for further assessment, the number of difficulties recognised or influence on outcomes.
  
  
  CONCLUSIONS
  The results may be explained by the inadequacy of the DAWBA, lack of statistical power to detect any effects that were present or a reluctance of some practitioners to use the DAWBA in their assessment. Future research might benefit from exploring the use of the DAWBA or similar assessments as a referral rather than an assessment tool, and exploring how practitioners and parents experience and use the DAWBA and what training might optimise the utility of the DAWBA to clinical practice.
authors.affiliation: Peninsula Medical School, University of Exeter, Veysey Building, Salmon Pool Lane, Exeter, EX2 4SG, UK. tamsin.ford@pms.ac.uk
authors.forename: Tamsin
authors.initials: T
authors.lastname: Ford
authors.forename: Anna
authors.initials: A
authors.lastname: Last
authors.forename: William
authors.initials: W
authors.lastname: Henley
authors.forename: Shelley
authors.initials: S
authors.lastname: Norman
authors.forename: Sacha
authors.initials: S
authors.lastname: Guglani
authors.forename: Katerina
authors.initials: K
authors.lastname: Kelesidi
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Martin
authors.forename: Pippa
authors.initials: P
authors.lastname: Moran
authors.forename: Harriett
authors.initials: H
authors.lastname: Latham-Cork
authors.forename: Robert
authors.initials: R
authors.lastname: Goodman
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis*; D002675:Child, Preschool; D003936:Diagnosis, Computer-Assisted / Q000379:methods* / Q000592:standards; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D010818:Practice Patterns, Physicians'; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D006113:United Kingdom