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Broad Outcome Measures May Underestimate Effectiveness: An Instrument Comparison Study.

William Lee1, Lynne Jones2, Robert Goodman3

  • 1Academic Dept of Psychological Medicine, GKT School of Medicine & Institute of Psychiatry, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK.

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Child and adolescent mental health services should use both broad and narrow outcome measures. Narrower questionnaires increase the power to detect significant intervention changes in youth with Obsessive Compulsive Disorder (OCD).

Keywords:
Obsessive Compulsive DisorderOutcomequestionnaire

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Area of Science:

  • Child and Adolescent Psychiatry
  • Clinical Psychology
  • Mental Health Services Research

Background:

  • Outcome measures are essential in child and adolescent mental health services to evaluate intervention effectiveness.
  • Standardized assessment tools are crucial for demonstrating treatment outcomes.
  • Utilizing appropriate measures ensures accountability and quality improvement in clinical practice.

Purpose of the Study:

  • To compare the sensitivity of outcome measures with varying breadth in a youth Obsessive Compulsive Disorder (OCD) service.
  • To determine how questionnaire breadth impacts the detection of treatment effects.
  • To provide evidence-based recommendations for outcome measure selection in specialist child mental health clinics.

Main Methods:

  • A consecutive sample of young people from a hospital's OCD service was assessed.
  • Improvements were measured using instruments of differing breadth.
  • Effect sizes were calculated to compare the sensitivity of various questionnaires.

Main Results:

  • A significant inverse relationship was observed between questionnaire breadth and effect size.
  • Broader questionnaires yielded smaller effect sizes, indicating reduced sensitivity to change.
  • Narrower, more specific instruments demonstrated greater power in detecting intervention effects.

Conclusions:

  • Specialist child and adolescent mental health services should employ a dual-questionnaire approach for outcome measurement.
  • A broad questionnaire facilitates comparability across different clinics and services.
  • A narrow questionnaire maximizes statistical power for detecting significant changes in youth with OCD.