title: Predicting individual change during the course of treatment.
abstract: An empirically derived prediction model was developed in a private practice setting to monitor on-track and off-track weekly treatment progress in an intensive outpatient program (IOP).
  
  
  
  The predictive equation was derived as a function of the baseline measure and time. The formulae for the predictive equations were derived from two groups of psychiatric patients (N = 400 each) in an IOP diagnosed with major depression. Each equation was cross-validated between these two psychiatric IOP samples and a dual diagnosis sample (N = 198) using κ, the reliable change index (RCI), receiver operating characteristic curves, and Youden's J.
  
  
  
  Using varying RCI classifications, approximately 66-75% of both samples reliably improved, 23-24% were indeterminant, and only 1-3% deteriorated. Of patients identified as off-track, which included patients classified as indeterminant and deteriorated, 83% were correctly identified. Of those identified as on-track, 85% were correctly classified. Those identified as on-track (85%) are highly likely to respond to treatment as expected.
  
  
  
  The overall efficiency index (hit rate) for the correct classification of all patients was 85%. Implications for using this predictive model as a clinical support decision tool with relatively homogeneous populations in other practice settings are discussed.
authors.affiliation: a Mental Health Resources, PLLC , Memphis , TN , USA.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Wise
authors.affiliation: b Department of Psychiatry , McMaster University , St. Joseph's Healthcare, Hamilton , Ontario , Canada.|c Department of Psychiatry , University of Toronto , ON , Canada.
authors.forename: David L
authors.initials: DL
authors.lastname: Streiner
authors.affiliation: d Applied Statistics Program, Department of Mathematics , West Chester University , West Chester , PA , USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Gallop
mesh_terms: D000328:Adult; D000066491:Clinical Decision-Making; D003661:Decision Support Techniques; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010045:Outpatients; D011379:Prognosis; D011613:Psychotherapy / Q000379:methods* / Q000592:standards
keywords: intensive outpatient; predicting change; psychotherapy outcomes; routine outcomes monitoring