Standardization of health outcomes assessment for depression and anxiety

recommendations from the ICHOM Depression and Anxiety Working Group

Alexander Obbarius*, Lisa van Maasakkers, Lee Baer, David M. Clark, Anne G. Crocker, Edwin de Beurs, Paul M. G. Emmelkamp, Toshi A. Furukawa, Erik Hedman-Lagerlöf, Maria Kangas, Lucie Langford, Alain Lesage, Doris M. Mwesigire, Sandra Nolte, Vikram Patel, Paul A. Pilkonis, Harold A. Pincus, Roberta A. Reis, Graciela Rojas, Cathy Sherbourne & 4 others Dave Smithson, Caleb Stowell, Kelly Woolaway-Bickel, Matthias Rose

*Corresponding author for this work

Research output: Contribution to journalArticle

24 Citations (Scopus)
17 Downloads (Pure)

Abstract

Purpose: National initiatives, such as the UK Improving Access to Psychological Therapies program (IAPT), demonstrate the feasibility of conducting empirical mental health assessments on a large scale, and similar initiatives exist in other countries. However, there is a lack of international consensus on which outcome domains are most salient to monitor treatment progress and how they should be measured. The aim of this project was to propose (1) an essential set of outcome domains relevant across countries and cultures, (2) a set of easily accessible patient-reported instruments, and (3) a psychometric approach to make scores from different instruments comparable. Methods: Twenty-four experts, including ten health outcomes researchers, ten clinical experts from all continents, two patient advocates, and two ICHOM coordinators worked for seven months in a consensus building exercise to develop recommendations based on existing evidence using a structured consensus-driven modified Delphi technique. Results: The group proposes to combine an assessment of potential outcome predictors at baseline (47 items: demographics, functional, clinical status, etc.), with repeated assessments of disease-specific symptoms during the treatment process (19 items: symptoms, side effects, etc.), and a comprehensive annual assessment of broader treatment outcomes (45 items: remission, absenteeism, etc.). Further, it is suggested reporting disease-specific symptoms for depression and anxiety on a standardized metric to increase comparability with other legacy instruments. All recommended instruments are provided online (www.ichom.org). Conclusion: An international standard of health outcomes assessment has the potential to improve clinical decision making, enhance health care for the benefit of patients, and facilitate scientific knowledge.

Original languageEnglish
Pages (from-to)3211–3225
Number of pages15
JournalQuality of Life Research
Volume26
Issue number12
DOIs
Publication statusPublished - Dec 2017

Bibliographical note

Copyright the Author(s) 2017. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • depression
  • anxiety
  • patient-reported outcomes
  • health-related quality of life
  • standardization
  • outcome Set

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