Transdiagnostic Clinical Global Impression Scoring for Routine Clinical Settings

Area of Science:

• Psychiatry
• Clinical Psychology
• Psychometric Evaluation

Background:

• Standardized, transdiagnostic measures are needed for tracking patient change in routine clinical care.
• Current Clinical Global Impression (CGI) scales are widely used but have poorly defined, disease-specific anchors, limiting broad clinical adoption.
• Existing efforts to improve CGI anchors are hampered by their disease-specific nature.

Purpose of the Study:

• To inform the development of broadly applicable CGI scoring anchors.
• To create a standardized, transdiagnostic measure for routine clinical use in psychiatry.
• To enhance the utility of CGI scales for assessing treatment efficacy across diverse psychiatric illnesses.

Main Methods:

• Surveyed 24 clinical trial investigators on elements influencing CGI-Severity (CGI-S) scoring.
• Investigated the relative importance of symptom severity, functional status, self-report, staff observations, and side effects.
• Integrated survey findings with existing illness-specific CGI anchors to develop the Transdiagnostic CGI (T-CGI).

Main Results:

• Symptom severity was ranked as the most crucial element for CGI-S scoring.
• Patient functional status was identified as the second most important element.
• The relative importance of these elements did not vary significantly with investigator experience or patient interaction time.

Conclusions:

• The Transdiagnostic CGI (T-CGI) was developed using standardized scoring anchors applicable across psychiatric conditions.
• The T-CGI aims to be a simple and useful measure for routine clinical settings and electronic medical records.
• Further validity and reliability evaluations are pending for the T-CGI's clinical implementation.