Convergent validity of the ASAM Patient Placement Criteria using a standardized computer algorithm

The study examined the convergent validity of the ASAM Patient Placement Criteria (PPC) by comparing Level of Care (LOC) recommendations produced by two alternative methods: a computerdriven algorithm and a "standard" clinical assessment. A cohort of 248 applicants for alcoholism treatment were evaluated at a multi-modality treatment center. The two methods disagreed (58% of cases) more often than they agreed (42%). The algorithm recommended a more intense LOC than the clinician protocol in 81% of the discrepant cases. Four categories of disagreement accounted for 97% of the discrepant cases. Several major sources of disagreement were identified and examined in detail: clinicians' reasoned departures from the PPC rules, conservatism in algorithm LOC recommendations, and measurement overlap between two specific dimensions. In order for the ASAM PPC and its associated algorithm to be embraced by treatment programs, the observed differences in LOC recommendations between the algorithm and "standard" clinical assessment should be resolved.