Related Experiment Videos
The procedural validity of retrospective case note diagnosis
C Mihalopoulos1, P McGorry, S Roberts
1Early Psychosis Research Centre, University of Melbourne Department of Psychiatry, Parkville, Victoria, Australia.
The Australian and New Zealand Journal of Psychiatry
|February 24, 2001
Summary
Diagnoses from retrospective case notes using the Operational Criteria (OPCRIT) checklist show poor validity. Direct patient interviews and informant data are crucial for accurate psychiatric diagnoses.
Area of Science:
- Psychiatry
- Psychopathology
- Clinical Research
Background:
- Retrospective case note examination is common in psychiatric research.
- The Operational Criteria (OPCRIT) checklist aims for reliable diagnoses from case notes.
- The validity of OPCRIT compared to prospective methods was untested.
Purpose of the Study:
- To examine the procedural validity of the OPCRIT diagnostic system.
- To compare OPCRIT diagnoses with four other diagnostic procedures using prospectively gathered information.
Main Methods:
- Three raters used OPCRIT to assess case notes and clinical abstracts of 50 subjects.
- Subjects were part of a DSM-IV Field Trial for psychotic disorders.
- The study setting was the Early Psychosis Prevention and Intervention Centre (EPPIC).
Main Results:
- Pairwise concordance between OPCRIT and other procedures was poor to moderate.
- Agreement for OPCRIT clinical abstracts ranged from 49-60% (kappa 0.30-0.45).
- Agreement for OPCRIT case notes ranged from 44-57% (kappa 0.35-0.49).
Conclusions:
- Diagnoses from OPCRIT checklists using only case notes/abstracts are unacceptably poor.
- These sources require supplementation with direct patient interviews.
- Informant material is also essential for robust diagnostic validity.