Measurement-Based Care and Applying Statistical Concepts to the Individual Patient

Joseph F. Goldberg; Stephen M. Stahl

doi:10.1017/9781009181549.008

6 - Measurement-Based Care and Applying Statistical Concepts to the Individual Patient

Published online by Cambridge University Press: 25 March 2024

Joseph F. Goldberg and

Stephen M. Stahl

Show author details

Joseph F. Goldberg: Affiliation:
Icahn School of Medicine at Mount Sinai, New York
Stephen M. Stahl: Affiliation:
University of California San Diego

Book contents

Get access

Summary

“Measurement-based care” (MBC) refers to the systematic assessment of patients’ symptoms over the course of some observation period in order to glean information about likely treatment effects. The concept grew mainly from the world of clinical trials and US Food and Drug Administration registration studies, where efforts to judge the efficacy of an intervention depended on reliable quantifiable measures to track changes in symptoms or clinical status over time. In this chapter, our interest in MBC pertains mainly to describing the ways in which it can impact hypothesis-testing, decision-making, and outcome-tracking in clinical practice rather than in research settings.

Type: Chapter
Information: Clinical Reasoning and Decision-Making in Psychiatry , pp. 145 - 176

DOI: https://doi.org/10.1017/9781009181549.008 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Subscription

Individual access

Subscriptions are only available for individuals and not institutional access. Subscribe now

References

Aiken, CB, Weisler, RH, Sachs, GS.The Bipolarity Index: A clinician-rated measure of diagnostic confidence. J Affect Disord 2015; 177: 59–64CrossRef Google Scholar PubMed

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association, 2000Google Scholar

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Washington, DC: American Psychiatric Association, 2013Google Scholar

Andreasen, NC.The Scale for the Assessment of Negative Symptoms (SANS). Iowa City, Iowa: The University of Iowa, 1983Google Scholar

Andreasen, NC.The Scale for the Assessment of Positive Symptoms (SAPS). Iowa City, Iowa: The University of Iowa, 1984Google Scholar

Barnes, TR.A rating scale for drug-induced akathisia. Br J Psychiatry 1989; 154: 672–676CrossRef Google Scholar PubMed

Beck, AT, Steer, RA, Ball, R, et al.Comparison of Beck Depressive Inventories -IA and II in psychiatric outpatients. J Personality Assess 1996; 67: 588–597CrossRef Google Scholar

Bernstein, IH, Rush, AJ, Carmody, TJ, et al.Clinical versus self-report versions of the Quick Inventory of Depressive Symptoms in a public sector sample. J Psychiatr Res 2007; 41: 239–246CrossRef Google Scholar

Blake, DD, Weathers, FW, Nagy, LM, et al.A clinician rating scale for assessing current and lifetime PTSD: The CAPS-1. Behav Therap 1990; 13: 187–188Google Scholar

Bobes, J, Rubio, G, Téran, A, et al.Pregabalin for the discontinuation of long-term benzodiazepines use: An assessment of its effectiveness in daily clinical practice. Eur Psychiatry 2012; 27: 301–307CrossRef Google Scholar PubMed

Bondolfi, G, Germann, F, Weber Rouget, B, et al.Self- and clinician-rated Montgomery–Åsberg Depression Rating Scale: Evaluation in clinical practice. J Affect Disord 2010; 121: 268–272CrossRef Google Scholar PubMed

Burdick, KE, Endick, CJ, Goldberg, JF.Assessing cognitive deficits in bipolar disorder: Are self-reports valid? Psychiatry Res 2005; 136: 43–50CrossRef Google Scholar PubMed

Chamberlain, SR, Cortese, S, Grant, JE.Screening for adult ADHD using brief rating tools: What can we conclude from a positive screen? Some caveats. Compr Psychiatry 2021; 106: 152224CrossRef Google Scholar PubMed

Del Fabro, L, Bondi, E, Serio, F, et al.Machine learning methods to predict outcomes of pharmacological treatment in psychosis. Transl Psychiatry 2023; 13(1): 75CrossRef Google Scholar PubMed

Derogatis, LR, Savitz, KL.The SCL-90-R, Brief Symptom Inventory, and matching clinical rating scales. In Maruish, ME (ed.), The Use of Psychological Testing for Treatment Planning and Outcomes Assessment. New York: Routledge, 2000, pp. 679–724Google Scholar

Endicott, J, Nee, J, Harrison, W, et al.Quality of Life Enjoyment and Satisfaction Questionnaire: A new measure. Psychopharmacol Bull 1993; 29: 321–326Google Scholar PubMed

Fekadu, A, Wooderson, S, Donaldson, C, et al.A multidimensional tool to quantify treatment resistance in depression: The Maudsley Staging Method. J Clin Psychiatry 2009; 70: 177–184CrossRef Google Scholar PubMed

Goldberg, JF.Perspectives on the success rate of current antidepressant pharmacotherapy. Expert Opin Pharmacother 2022; 23: 1781–1791CrossRef Google Scholar PubMed

Goldberg, JF, Garakani, A, Ackerman, SH.Clinician-rated versus self-rated screening for bipolar disorder among inpatients with mood symptoms and substance misuse. J Clin Psychiatry 2012; 73: 1525–1530CrossRef Google Scholar PubMed

Goodman, WK, Price, LH, Rasmussen, SA, et al.The Yale-Brown Obsessive-Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry 1989; 46: 1006–1011CrossRef Google Scholar PubMed

Green, KL, Brown, GK, Jager-Hyman, S, et al.The predictive validity of the Beck Depression Inventory suicide item. J Clin Psychiatry 2015; 76: 1683–1686CrossRef Google Scholar PubMed

Guo, T, Xiang, Y-T, Xiao, L, et al.Measurement-based care versus standard care for major depression: A randomized controlled trial with blind raters. Am J Psychiatry 2015; 172: 1004–1013CrossRef Google Scholar PubMed

Guy, W.Clinical Global Impressions. In ECDEU Assessment Manual for Psychopharmacology – Revised. Rockville, MD: US Department of Health, Education, and Welfare, 1976a, pp. 218–222Google Scholar

Guy, W.Abnormal Involuntary Movement Scale (AIMS). In ECDEU Assessment Manual for Psychopharmacology – Revised. Rockville, MD: US Department of Health, Education, and Welfare, 1976b, pp. 534–537Google Scholar

Hadley, SJ, Mandel, FS, Schweizer, E.Switching from long-term benzodiazepine therapy to pregabalin in patients with generalized anxiety disorder: A double-blind, placebo-controlled trial. J Psychopharmacol 2012; 26: 461–470CrossRef Google Scholar PubMed

Hamilton, M.The assessment of anxiety states by rating. Br J Med Psychol 1959; 32: 50–55CrossRef Google Scholar PubMed

Hamilton, M.A rating scale for depression. J Neurol Neursurg Psychiatry 1960; 23: 56–62CrossRef Google Scholar PubMed

Hirschfeld, RMA, Holzer, C, Calabrese, JR, et al.Validity of the Mood Disorder Questionnaire: A general population study. Am J Psychiatry 2003; 160: 178–180CrossRef Google Scholar PubMed

Hohagen, A, Münchau, N, Hiss, H, et al.Combination of behaviour therapy with fluvoxamine in comparison with behaviour therapy and placebo. Results of a multicentre study. Br J Psychiatry Suppl 1998; 35: 71–78CrossRef Google Scholar

Johns, MW.A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep 1991; 14: 540–545CrossRef Google Scholar PubMed

Kay, SR, Fiszbein, A, Opler, LA.The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schiz Bull 1987; 13: 261–276CrossRef Google Scholar PubMed

Koutsouleris, N, Dwyer, DB, Degenhardt, F, et al.Multimodal machine learning workflows for prediction of psychosis in patients with clinical high-risk syndromes and recent-onset depression. JAMA Psychiatry 2021; 78: 195–209CrossRef Google Scholar PubMed

Kroenke, K, Spitzer, RL, Williams, JB.The PHQ-9: Validity of a brief depression severity measure. J Gen Int Med 2001; 16: 606–613CrossRef Google Scholar PubMed

Leucht, S, Kane, JM, Kissling, W, et al.What does the PANSS mean? Schizophr Res 2005a; 79: 231–238CrossRef Google Scholar PubMed

Leucht, S, Kane, JM, Kissling, W.Clinical implications of Brief Psychiatric Rating Scale scores. Br J Psychiatry 2005b; 187: 366–371CrossRef Google Scholar PubMed

Lewis, CC, Boyd, M, Puspitasari, A, et al.Implementing measurement-based care in behavioral health: A review. JAMA Psychiatry 2019; 76: 324–335CrossRef Google Scholar PubMed

Liebowitz, MR.Social phobia. Mod Probl Pharmacopsychiatry 1987; 22: 141–173CrossRef Google Scholar PubMed

McGahuey, CA, Gelenberg, AJ, Laukes, CA, et al.The Arizona Sexual Experience Scale (ASEX): Reliability and validity. J Sex Marital Ther 2000; 26: 25–40Google Scholar PubMed

McIntyre, RS, Patel, MD, Masand, PS, et al.The Rapid Mood Screener (RMS): A novel and pragmatic screener for bipolar I disorder. Curr Med Res Opin 2021; 37: 135–144CrossRef Google Scholar PubMed

Montgomery, SA, Åsberg, M.A new depression scale designed to be sensitive to change. Br J Psychiatry 1979; 134: 382–389CrossRef Google Scholar PubMed

Nasreddine, ZS, Phillips, NA, Bédirian, V, et al.The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53: 695–699CrossRef Google Scholar

Nelson, CJ, Baumann, P, Delucchi, K, et al.A systematic review and meta-analysis of lithium augmentation of tricyclic and second generation antidepressants in major depression. J Affect Disord 2014; 168: 269–275CrossRef Google Scholar PubMed

Overall, JE, Gorham, DR.The Brief Psychiatric Rating Scale. Psychol Rep 1962; 10: 799–812CrossRef Google Scholar

Patton, JH, Stanford, MS, Barratt, ES.Factor structure of the Barratt Impulsiveness Scale. J Clin Psychol 1995; 51: 768–7743.0.CO;2-1>CrossRef Google Scholar PubMed

Peterson, K, Anderson, J, Bourne, D.Evidence brief: Use of patient reported outcome measures for measurement based care in mental health shared decision making. Washington, DC: Department of Veterans Affairs (US), 2018Google Scholar PubMed

Posner, K, Brown, GK, Stanley, B, et al.The Columbia–Suicide Severity Rating Scale: Initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry 2011; 168, 1266–1277CrossRef Google Scholar PubMed

Rojo, E, Pino, O, Guilera, G, et al.Neurocognitive diagnosis and cut-off scores of the Screen for Cognitive Impairment in Psychiatry (SCIP-S). Schizophr Res 2010; 116: 243–251CrossRef Google Scholar PubMed

Rosa, AR, Sánchez-Moreno, J, Martínez-Aran, A, et al.Validity and reliability of the Functioning Assessment Short Test (FAST) in bipolar disorder. Clin Pract Epidemiol Mental Health 2007; 3: 5CrossRef Google Scholar PubMed

Ruhé, HG, van Rooijen, G, Spijker, J, et al.Staging methods for treatment resistant depression. A systematic review. J Affect Disord 2012; 137: 35–45CrossRef Google Scholar PubMed

Rush, AJ, Trivedi, MH, Ibrahim, HM, et al.The 16-item Quick Inventory of Depressive Symptomatology (QIDS), clinician-rating (QIDS-C), and self-report (QIDS-SR): A psychometric evaluation in patients with chronic major depression. Biol Psychiatry 2003; 54: 573–583CrossRef Google Scholar PubMed

Salem, S, Huynh, T, Topolski, N, et al.Temporal multi-step predictive modeling of remission in major depressive disorder using early stage treatment data: STAR*D based machine learning approach. J Affect Disord 2023; 324: 286–293CrossRef Google Scholar PubMed

Saunders, JB, Aasland, OG, Babor, TF, et al.Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption – II. Addiction 1993; 88: 791–804CrossRef Google Scholar PubMed

Sheehan, DV, Harnett-Sheehan, K, Raj, BA.The measurement of disability. Int Clin Psychopharmacol 1996; 11 (Suppl 3): 89–95CrossRef Google Scholar PubMed

Simpson, GM, Angus, JWS.A rating scale for extrapyramidal side effects. Acta Psychiatr Scand (Suppl) 1970; 212: 11–19CrossRef Google Scholar PubMed

Snaith, RP, Hamilton, M, Morley, S, et al.A scale for the assessment of hedonic tone the Snaith–Hamilton Pleasure Scale. Br J Psychiatry 1995; 167: 99–103CrossRef Google Scholar PubMed

Spielberger, CD, Gorsuch, RL, Lushene, RE, et al.Manual for the State–Trait Anxiety Inventory (Form Y). Palo Alto, CA: Consulting Psychologists Press, 1983Google Scholar

Spitzer, RL, Kroenke, K, Williams, JB, et al.A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Int Med 2006; 166: 1092–1097CrossRef Google Scholar PubMed

Taubitz, FS, Büdenbender, B, Alpers, GW.What the future holds: Machine learning to predict success in psychotherapy. Behav Res Ther 2022; 156: 104116CrossRef Google Scholar PubMed

Tenneij, NH, van Megen, HJGM, Denys, DA, et al.Behavior therapy augments response of patients with obsessive–compulsive disorder responding to drug treatment. J Clin Psychiatry 2005; 66: 1169–1175CrossRef Google Scholar PubMed

Tondo, L, Burrai, C, Scamonatti, L, et al.Comparison between clinician-rated and self-reported depressive symptoms in Italian psychiatric patients. Neuropsychobiology 1988; 19: 1–5CrossRef Google Scholar PubMed

Ustun, B, Adler, LA, Rudin, C, et al.The World Health Organization Adult Attention-Deficit/Hyperactivity Disorder self-report screening scale for DSM-5. JAMA Psychiatry 2017; 74: 520–526CrossRef Google Scholar PubMed

Weathers, FW, Litz, BT, Keane, TM, et al.The PTSD Checklist for DSM-5 (PCL-5). Boston, MA: National Center for PTSD, 2013Google Scholar

Wisniewski, SR, Rush, AJ, Balasubramani, GK, et al.Self-rated global measure of the frequency, intensity, and burden of side effects. J Psychiatr Pract 2006; 12: 71–79CrossRef Google Scholar PubMed

World Health Organization.WHO Psychiatric Disability Assessment Schedule. Geneva: WHO; 1988Google Scholar

Wu, C-S, Luedtke, AR, Sadikova, E, et al.Development and validation of a machine learning individualized treatment rule in first-episode schizophrenia. JAMA Netw Open 2020; 3(2): e1921660CrossRef Google Scholar PubMed

Yao, L, Zhao, X, Xu, Z, et al.Influencing factors and machine learning-based prediction of side effects in psychotherapy. Front Psychiatry 2020; 11: 537442CrossRef Google Scholar PubMed

Young, RC, Biggs, JT, Ziegler, VE, et al.A rating scale for mania: Reliability, validity and sensitivity. Br J Psychiatry 1978; 133: 429–435CrossRef Google Scholar PubMed

Zimmerman, M, Galione, JN.Screening for bipolar disorder with the mood disorders questionnaire: A review. Harv Rev Psychiatry 2011; 19: 219–228CrossRef Google Scholar PubMed

Zimmerman, M, McGlinchey, JB.Why don’t psychiatrists use scales to measure outcome when treating depressed patients? J Clin Psychiatry 2008; 69: 1916–1919CrossRef Google Scholar PubMed

Zimmerman, M, Martinez, J, Attiulah, N, et al.Why do some depressed outpatients who are in remission according to the Hamilton Depression Rating Scale not consider themselves to be in remission? J Clin Psychiatry 2012a; 73: 790–795CrossRef Google Scholar

Zimmerman, M, Martinez, J, Attiulah, N, et al.Why do some depressed outpatients who are not in remission according to the Hamilton Depression Rating Scale nonetheless consider themselves to be in remission? Depress Anxiety 2012b; 29: 891–895CrossRef Google Scholar PubMed