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Transdiagnostic Clinical Global Impression Scoring for Routine Clinical Settings

Although there is great interest in the improving the ability to track patients’ change over time in routine clinical care settings, no standardized transdiagnostic measure is currently available for busy clinicians to apply. The Clinical Global Impression (CGI) scales are simple measures widely use...

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Autores principales: Dunlop, Boadie W., Gray, Jaclyn, Rapaport, Mark H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618048/
https://www.ncbi.nlm.nih.gov/pubmed/28653978
http://dx.doi.org/10.3390/bs7030040
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author Dunlop, Boadie W.
Gray, Jaclyn
Rapaport, Mark H.
author_facet Dunlop, Boadie W.
Gray, Jaclyn
Rapaport, Mark H.
author_sort Dunlop, Boadie W.
collection PubMed
description Although there is great interest in the improving the ability to track patients’ change over time in routine clinical care settings, no standardized transdiagnostic measure is currently available for busy clinicians to apply. The Clinical Global Impression (CGI) scales are simple measures widely used as outcomes in psychiatric clinical trials. However, the CGI suffers from poorly defined scoring anchors. Efforts to improve the anchors by enhancing the anchor descriptions have proven useful but are limited by being disease-specific, thereby acting as a barrier to the routine clinical adoption of the CGI. To inform the development of more broadly applicable CGI scoring anchors, we surveyed 24 clinical trial investigators, asking them to rank-order seven elements that inform their CGI-Severity (CGI-S) scoring. Symptom severity emerged as the most important element in determining CGI-S scores; the functional status of the patient emerged as a second element. Less importance was given to self-report symptom scores, staff observations, or side effects. Relative rankings of the elements’ importance did not differ by investigators’ experience nor time usually spent with patients. We integrated these results with published illness-specific CGI anchors to develop the Transdiagnostic CGI (T-CGI), which employs standardized scoring anchors applicable across psychiatric illnesses. Pending validity and reliability evaluations, the T-CGI may prove well-suited for inclusion in routine clinical settings and for incorporation into electronic medical records as a simple and useful measure of treatment efficacy.
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spelling pubmed-56180482017-09-29 Transdiagnostic Clinical Global Impression Scoring for Routine Clinical Settings Dunlop, Boadie W. Gray, Jaclyn Rapaport, Mark H. Behav Sci (Basel) Concept Paper Although there is great interest in the improving the ability to track patients’ change over time in routine clinical care settings, no standardized transdiagnostic measure is currently available for busy clinicians to apply. The Clinical Global Impression (CGI) scales are simple measures widely used as outcomes in psychiatric clinical trials. However, the CGI suffers from poorly defined scoring anchors. Efforts to improve the anchors by enhancing the anchor descriptions have proven useful but are limited by being disease-specific, thereby acting as a barrier to the routine clinical adoption of the CGI. To inform the development of more broadly applicable CGI scoring anchors, we surveyed 24 clinical trial investigators, asking them to rank-order seven elements that inform their CGI-Severity (CGI-S) scoring. Symptom severity emerged as the most important element in determining CGI-S scores; the functional status of the patient emerged as a second element. Less importance was given to self-report symptom scores, staff observations, or side effects. Relative rankings of the elements’ importance did not differ by investigators’ experience nor time usually spent with patients. We integrated these results with published illness-specific CGI anchors to develop the Transdiagnostic CGI (T-CGI), which employs standardized scoring anchors applicable across psychiatric illnesses. Pending validity and reliability evaluations, the T-CGI may prove well-suited for inclusion in routine clinical settings and for incorporation into electronic medical records as a simple and useful measure of treatment efficacy. MDPI 2017-06-27 /pmc/articles/PMC5618048/ /pubmed/28653978 http://dx.doi.org/10.3390/bs7030040 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Concept Paper
Dunlop, Boadie W.
Gray, Jaclyn
Rapaport, Mark H.
Transdiagnostic Clinical Global Impression Scoring for Routine Clinical Settings
title Transdiagnostic Clinical Global Impression Scoring for Routine Clinical Settings
title_full Transdiagnostic Clinical Global Impression Scoring for Routine Clinical Settings
title_fullStr Transdiagnostic Clinical Global Impression Scoring for Routine Clinical Settings
title_full_unstemmed Transdiagnostic Clinical Global Impression Scoring for Routine Clinical Settings
title_short Transdiagnostic Clinical Global Impression Scoring for Routine Clinical Settings
title_sort transdiagnostic clinical global impression scoring for routine clinical settings
topic Concept Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618048/
https://www.ncbi.nlm.nih.gov/pubmed/28653978
http://dx.doi.org/10.3390/bs7030040
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