title: Assessment of Biopsychosocial Complexity and Health Care Needs: Measurement Properties of the INTERMED Self-Assessment Version.
abstract: OBJECTIVE
  The INTERMED Self-Assessment questionnaire (IMSA) was developed as an alternative to the observer-rated INTERMED (IM) to assess biopsychosocial complexity and health care needs. We studied feasibility, reliability, and validity of the IMSA within a large and heterogeneous international sample of adult hospital inpatients and outpatients as well as its predictive value for health care use (HCU) and quality of life (QoL).
  
  
  METHODS
  A total of 850 participants aged 17 to 90 years from five countries completed the IMSA and were evaluated with the IM. The following measurement properties were determined: feasibility by percentages of missing values; reliability by Cronbach α; interrater agreement by intraclass correlation coefficients; convergent validity of IMSA scores with mental health (Short Form 36 emotional well-being subscale and Hospital Anxiety and Depression Scale), medical health (Cumulative Illness Rating Scale) and QoL (Euroqol-5D) by Spearman rank correlations; and predictive validity of IMSA scores with HCU and QoL by (generalized) linear mixed models.
  
  
  RESULTS
  Feasibility, face validity, and reliability (Cronbach α = 0.80) were satisfactory. Intraclass correlation coefficient between IMSA and IM total scores was .78 (95% CI = .75-.81). Correlations of the IMSA with the Short Form 36, Hospital Anxiety and Depression Scale, Cumulative Illness Rating Scale, and Euroqol-5D (convergent validity) were -.65, .15, .28, and -.59, respectively. The IMSA significantly predicted QoL and also HCU (emergency department visits, hospitalization, outpatient visits, and diagnostic examinations) after 3- and 6-month follow-up. Results were comparable between hospital sites, inpatients and outpatients, as well as age groups.
  
  
  CONCLUSIONS
  The IMSA is a generic and time-efficient method to assess biopsychosocial complexity and to provide guidance for multidisciplinary care trajectories in adult patients, with good reliability and validity across different cultures.
authors.affiliation: From the Department of (Liaison) Psychiatry (van Reedt Dortland, Boenink, Smit, Hoogendoorn), VU University Medical Centre/GGZ inGeest, Amsterdam, The Netherlands; Department of Midwifery Science (Peters), AVAG EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Leyden Academy on Vitality and Ageing (Slaets), Leiden, The Netherlands; Department of Psychosomatic Medicine and Psychotherapy (Joos), UMC Freiburg, Germany; Amsterdam Centre for Innovative Health Practice (Latour), Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands; Academic Medical Centre Amsterdam (Latour), The Netherlands; Service of Liaison Psychiatry (Stiefel), University and University Hospital Lausanne, Switzerland; Department of Musculoskeletal Rehabilitation (Burrus), Sion, Switzerland; Consultation-Liaison Psychiatry Unit (Guitteny-Collas), Department of Addictology and CL-Psychiatry, University Hospital of Nantes, France; and Department of Diagnostic-Clinical Medicine and Public Health (Ferrari), Section of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Arianne K B
authors.initials: AKB
authors.lastname: van Reedt Dortland
authors.forename: Lilian L
authors.initials: LL
authors.lastname: Peters
authors.forename: Annette D
authors.initials: AD
authors.lastname: Boenink
authors.forename: Jan H
authors.initials: JH
authors.lastname: Smit
authors.forename: Joris P J
authors.initials: JPJ
authors.lastname: Slaets
authors.forename: Adriaan W
authors.initials: AW
authors.lastname: Hoogendoorn
authors.forename: Andreas
authors.initials: A
authors.lastname: Joos
authors.forename: Corine H M
authors.initials: CHM
authors.lastname: Latour
authors.forename: Friedrich
authors.initials: F
authors.lastname: Stiefel
authors.forename: Cyrille
authors.initials: C
authors.lastname: Burrus
authors.forename: Marie
authors.initials: M
authors.lastname: Guitteny-Collas
authors.forename: Silvia
authors.initials: S
authors.lastname: Ferrari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011584:Psychology; D011788:Quality of Life; D015203:Reproducibility of Results; D012307:Risk Factors; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D055815:Young Adult