A test of concordance between patient and psychiatrist valuations of multiple treatment goals for schizophrenia.

TY - JOUR

T1 - A test of concordance between patient and psychiatrist valuations of multiple treatment goals for schizophrenia.

AU - Bridges, John F P

AU - Slawik, Lara

AU - Schmeding, Annette

AU - Reimer, Jens

AU - Naber, Dieter

AU - Kuhnigk, Olaf

PY - 2013

Y1 - 2013

N2 - Background? While much discussion has been placed on the problem of poor compliance in the treatment of schizophrenia, there has been little discussion on the concordance between patients and psychiatrists, an important contributing factor to patient-centred care. Objective? To estimate the concordance between patients' and psychiatrists' (ordinal and cardinal) valuations of multiple goals for schizophrenia treatment and to illustrate the utility of the self-explicated method in valuing a large number of treatment goals. Design? Twenty treatment goals were identified during focus groups and literature review and were presented to patients and psychiatrists during structured interviews. Respondents were asked to rank the multiple treatment goals and rate them on a 5-point Likert scale. Three scores were calculated based on the ranking (1-20), rating (Likert scale) (1-5) and a self-explicated method estimated as the product of rating and ranking score (1-100). Concordance was tested using Spearman's rho for overall ordinal rankings and via anova and F-test for the cardinal values assigned to a specific treatment goal. Participants? A total of 105 outpatients diagnosed with schizophrenia and 160 psychiatrists in Germany. Results? Patient and psychiatrist values were concordant when the ordinal properties of their valuations were assessed by rating (??=?0.63; P?=?0.002), ranking (??=?0.51; P?=?0.02) and self-explicated methods (??=?0.54; P?=?0.01). Significant discordances were found when comparing the cardinal value placed on any given treatment goal using all three approaches, but the self-explicated method produced a more discerning statistic. Relative to patients, psychiatrists significantly (P?

AB - Background? While much discussion has been placed on the problem of poor compliance in the treatment of schizophrenia, there has been little discussion on the concordance between patients and psychiatrists, an important contributing factor to patient-centred care. Objective? To estimate the concordance between patients' and psychiatrists' (ordinal and cardinal) valuations of multiple goals for schizophrenia treatment and to illustrate the utility of the self-explicated method in valuing a large number of treatment goals. Design? Twenty treatment goals were identified during focus groups and literature review and were presented to patients and psychiatrists during structured interviews. Respondents were asked to rank the multiple treatment goals and rate them on a 5-point Likert scale. Three scores were calculated based on the ranking (1-20), rating (Likert scale) (1-5) and a self-explicated method estimated as the product of rating and ranking score (1-100). Concordance was tested using Spearman's rho for overall ordinal rankings and via anova and F-test for the cardinal values assigned to a specific treatment goal. Participants? A total of 105 outpatients diagnosed with schizophrenia and 160 psychiatrists in Germany. Results? Patient and psychiatrist values were concordant when the ordinal properties of their valuations were assessed by rating (??=?0.63; P?=?0.002), ranking (??=?0.51; P?=?0.02) and self-explicated methods (??=?0.54; P?=?0.01). Significant discordances were found when comparing the cardinal value placed on any given treatment goal using all three approaches, but the self-explicated method produced a more discerning statistic. Relative to patients, psychiatrists significantly (P?

U2 - 10.1111/j.1369-7625.2011.00704.x

DO - 10.1111/j.1369-7625.2011.00704.x

M3 - SCORING: Journal article

VL - 16

SP - 164

EP - 167

JO - HEALTH EXPECT

JF - HEALTH EXPECT

SN - 1369-6513

IS - 2

M1 - 2

ER -