Top

Published in:

Open Access 01-12-2017

Standardization of health outcomes assessment for depression and anxiety: recommendations from the ICHOM Depression and Anxiety Working Group

Authors: 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, Dave Smithson, Caleb Stowell, Kelly Woolaway-Bickel, Matthias Rose

Published in: Quality of Life Research | Issue 12/2017

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.

Available only for authorised users

Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., et al. (2012). Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380(9859), 2163–2196. doi:10.1016/S0140-6736(12)61729-2.CrossRefPubMed

Ferrari, A. J., Charlson, F. J., Norman, R. E., Patten, S. B., Freedman, G., Murray, C. J., et al. (2013). Burden of depressive disorders by country, sex, age, and year: Findings from the global burden of disease study 2010. PLoS Medicine, 10(11), e1001547. doi:10.1371/journal.pmed.1001547.CrossRefPubMedPubMedCentral

Greenberg, P. E., Fournier, A. A., Sisitsky, T., Pike, C. T., & Kessler, R. C. (2015). The economic burden of adults with major depressive disorder in the United States (2005 and 2010). Journal of Clinical Psychiatry, 76(2), 155–162. doi:10.4088/JCP.14m09298.CrossRefPubMed

Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., & Reynolds, C. F., 3rd. (2014). Adding psychotherapy to antidepressant medication in depression and anxiety disorders: A meta-analysis. World Psychiatry, 13(1), 56–67. doi:10.1002/wps.20089.CrossRefPubMedPubMedCentral

Middleton, H., Shaw, I., Hull, S., & Feder, G. (2005). NICE guidelines for the management of depression. BMJ, 330(7486), 267–268. doi:10.1136/bmj.330.7486.267.CrossRefPubMedPubMedCentral

Fonagy, P. (2010). Psychotherapy research: do we know what works for whom? British Journal of Psychiatry, 197(2), 83–85. doi:10.1192/bjp.bp.110.079657.CrossRefPubMed

Pilkonis, P. A., Choi, S. W., Reise, S. P., Stover, A. M., Riley, W. T., Cella, D., et al. (2011). Item banks for measuring emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS(R)): Depression, anxiety, and anger. Assessment, 18(3), 263–283. doi:10.1177/1073191111411667.CrossRefPubMedPubMedCentral

Rose, M., & Bezjak, A. (2009). Logistics of collecting patient-reported outcomes (PROs) in clinical practice: An overview and practical examples. Quality of Life Research, 18(1), 125–136. doi:10.1007/s11136-008-9436-0.CrossRefPubMed

Wahl, I., Lowe, B., Bjorner, J. B., Fischer, F., Langs, G., Voderholzer, U., et al. (2014). Standardization of depression measurement: A common metric was developed for 11 self-report depression measures. Journal of Clinical Epidemiology, 67(1), 73–86. doi:10.1016/j.jclinepi.2013.04.019.CrossRefPubMed

10.

Clark, D. M. (2011). Implementing NICE guidelines for the psychological treatment of depression and anxiety disorders: The IAPT experience. International Review of Psychiatry, 23(4), 318–327. doi:10.3109/09540261.2011.606803.CrossRefPubMedPubMedCentral

11.

Gyani, A., Shafran, R., Layard, R., & Clark, D. M. (2013). Enhancing recovery rates: Lessons from year one of IAPT. Behaviour Research and Therapy, 51(9), 597–606. doi:10.1016/j.brat.2013.06.004.CrossRefPubMedPubMedCentral

12.

Sveus – Swedish National collaboration for value-based reimbursement and monitoring of health care (2014). Retrieved November 26, 2014, from http://www.sveus.se/

13.

Boswell, J. F., Kraus, D. R., Miller, S. D., & Lambert, M. J. (2015). Implementing routine outcome monitoring in clinical practice: Benefits, challenges, and solutions. Psychotherapy Research, 25(1), 6–19. doi:10.1080/10503307.2013.817696.CrossRefPubMed

14.

Kramer, T. L., Evans, R. B., Landes, R., Mancino, M., Booth, B. M., & Smith, G. R. (2001). Comparing outcomes of routine care for depression: the dilemma of case-mix adjustment. Journal of Behavioral Health Services and Research, 28(3), 287–300.CrossRefPubMed

15.

Polit-O’Hara, D., & Hungler, B. P. (1997). Essentials of nursing research: Methods, appraisal, and utilization. New York: Lippincott.

16.

Hasson, F., Keeney, S., & McKenna, H. (2000). Research guidelines for the Delphi survey technique. Journal of Advanced Nursing, 32(4), 1008–1015.PubMed

17.

Clement, R. C., Welander, A., Stowell, C., Cha, T. D., Chen, J. L., Davies, M., et al. (2015). A proposed set of metrics for standardized outcome reporting in the management of low back pain. Acta Orthopaedica, 86(5), 523–533. doi:10.3109/17453674.2015.1036696.CrossRefPubMedPubMedCentral

18.

Mahmud, I., Kelley, T., Stowell, C., Haripriya, A., Boman, A., Kossler, I., et al. (2015). A proposed minimum standard set of outcome measures for cataract surgery. JAMA Ophthalmology, 133(11), 1247–1252. doi:10.1001/jamaophthalmol.2015.2810.CrossRefPubMed

19.

Mak, K. S., van Bommel, A. C., Stowell, C., Abrahm, J. L., Baker, M., Baldotto, C. S., et al. (2016). Defining a standard set of patient-centred outcomes for lung cancer. European Respiratory Journal. doi:10.1183/13993003.02049-2015.PubMedPubMedCentral

20.

Martin, N. E., Massey, L., Stowell, C., Bangma, C., Briganti, A., Bill-Axelson, A., et al. (2015). Defining a standard set of patient-centered outcomes for men with localized prostate cancer. European Urology, 67(3), 460–467. doi:10.1016/j.eururo.2014.08.075.CrossRefPubMed

21.

McNamara, R. L., Spatz, E. S., Kelley, T. A., Stowell, C. J., Beltrame, J., Heidenreich, P., et al. (2015). Standardized outcome measurement for patients with coronary artery disease: Consensus from the International Consortium for Health Outcomes Measurement (ICHOM). Journal of the American Heart Association. doi:10.1161/JAHA.115.001767.PubMedPubMedCentral

22.

Morgans, A. K., van Bommel, A. C., Stowell, C., Abrahm, J. L., Basch, E., Bekelman, J. E., et al. (2015). Development of a standardized set of patient-centered outcomes for advanced Prostate cancer: An international effort for a unified approach. European Urology, 68(5), 891–898. doi:10.1016/j.eururo.2015.06.007.CrossRefPubMed

23.

Rodrigues, I. A., Sprinkhuizen, S. M., Barthelmes, D., Blumenkranz, M., Cheung, G., Haller, J., et al. (2016). Defining a minimum set of standardized patient-centered outcome measures for macular degeneration. American Journal of Ophthalmology, 168, 1–12. doi:10.1016/j.ajo.2016.04.012.CrossRefPubMed

24.

Porter, M. E. (2010). What is value in health care? New England Journal of Medicine, 363(26), 2477–2481. doi:10.1056/NEJMp1011024.CrossRefPubMed

25.

Statistics Canada: Canadian Community Health Survey - Annual Component (CCHS) (2014). Retrieved November 11, 2014 from http://www.statcan.gc.ca/concepts/index-eng.htm

26.

Kickbusch, I. S. (2001). Health literacy: Addressing the health and education divide. Health Promotion International, 16(3), 289–297.CrossRefPubMed

27.

Allgaier, A. K., Pietsch, K., Fruhe, B., Sigl-Glockner, J., & Schulte-Korne, G. (2012). Screening for depression in adolescents: Validity of the patient health questionnaire in pediatric care. Depress Anxiety, 29(10), 906–913. doi:10.1002/da.21971.CrossRefPubMed

28.

Porter, M. E., & Teisberg, E. O. (2006). Redefining health care: Creating value-based competition on results. Boston: Harvard Business School Press.

29.

Spitzer, R. L., Kroenke, K., & Williams, J. B. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA, 282(18), 1737–1744.CrossRefPubMed

30.

Spitzer, R. L., Kroenke, K., Williams, J. B., & Lowe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. doi:10.1001/archinte.166.10.1092.CrossRefPubMed

31.

Choi, S. W., Schalet, B., Cook, K. F., & Cella, D. (2014). Establishing a common metric for depressive symptoms: Linking the BDI-II, CES-D, and PHQ-9 to PROMIS depression. Psychological Assessment, 26(2), 513–527. doi:10.1037/a0035768.CrossRefPubMedPubMedCentral

32.

Schalet, B. D., Cook, K. F., Choi, S. W., & Cella, D. (2014). Establishing a common metric for self-reported anxiety: Linking the MASQ, PANAS, and GAD-7 to PROMIS Anxiety. Journal of Anxiety Disorders, 28(1), 88–96. doi:10.1016/j.janxdis.2013.11.006.CrossRefPubMed

33.

Cella, D., Riley, W., Stone, A., Rothrock, N., Reeve, B., Yount, S., et al. (2010). The patient-reported outcomes measurement information system (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. Journal of Clinical Epidemiology, 63(11), 1179–1194. doi:10.1016/j.jclinepi.2010.04.011.CrossRefPubMedPubMedCentral

34.

Wells, K. B., Stewart, A., Hays, R. D., Burnam, M. A., Rogers, W., Daniels, M., et al. (1989). The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. JAMA, 262(7), 914–919.CrossRefPubMed

35.

Andrews, G., Kemp, A., Sunderland, M., Von Korff, M., & Ustun, T. B. (2009). Normative data for the 12 item WHO Disability Assessment Schedule 2.0. PLoS ONE, 4(12), e8343. doi:10.1371/journal.pone.0008343.CrossRefPubMedPubMedCentral

36.

Ustun, T. B., Chatterji, S., Kostanjsek, N., Rehm, J., Kennedy, C., Epping-Jordan, J., et al. (2010). Developing the World Health Organization disability assessment schedule 2.0. Bulletin of the World Health Organization, 88(11), 815–823. doi:10.2471/BLT.09.067231.CrossRefPubMedPubMedCentral

37.

de Beurs, E., Barendregt, M., de Heer, A., et al. (2016). Comparing methods to denote treatment outcome in clinical research and benchmarking mental health care. Clinical Psychology and Psychotherapy, 23, 308–318.CrossRefPubMed

38.

Jacobson, N. S., & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19.CrossRefPubMed

39.

Devilly, G. J., & Borkovec, T. D. (2000). Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 31(2), 73–86.CrossRefPubMed

40.

Braveman, P. A., Cubbin, C., Egerter, S., Chideya, S., Marchi, K. S., Metzler, M., et al. (2005). Socioeconomic status in health research: One size does not fit all. JAMA, 294(22), 2879–2888. doi:10.1001/jama.294.22.2879.CrossRefPubMed

41.

United Nations Educational, Scientific and Cultural Organization. International Standard Classification of Education: ISCED 2011. Retrieved November 10, 2015 from http://www.uis.unesco.org/Education/Documents/isced-2011-en.pdf

42.

Coles, J. (2010). PROMs risk adjustment methodology guide for general surgery and orthopaedic procedures. Retrieved November 10, 2015 from http://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2013/07/proms-ris-adj-meth-sur-orth.pdf

43.

van der Lem, R., Stamsnieder, P. M., van der Wee, N. J., van Veen, T., & Zitman, F. G. (2013). Influence of sociodemographic and socioeconomic features on treatment outcome in RCTs versus daily psychiatric practice. Social Psychiatry and Psychiatric Epidemiology, 48(6), 975–984. doi:10.1007/s00127-012-0624-4.CrossRefPubMed

44.

Holden, L., Lee, C., Hockey, R., Ware, R. S., & Dobson, A. J. (2014). Validation of the MOS Social Support Survey 6-item (MOS-SSS-6) measure with two large population-based samples of Australian women. Quality of Life Research, 23(10), 2849–2853. doi:10.1007/s11136-014-0741-5.CrossRefPubMed

45.

Guan, N. C., Sulaiman, A. R., Seng, L. H., Ann, A. Y., Wahab, S., & Pillai, S. K. (2013). Factorial validity and reliability of the Tamil version of multidimensional scale of perceived social support among a group of participants in university malaya medical centre, Malaysia. Indian Journal of Psychological Medicine, 35(4), 385–388. doi:10.4103/0253-7176.122234.CrossRefPubMedPubMedCentral

46.

Carter, J. D., Crowe, M. T., Jordan, J., McIntosh, V. V., Frampton, C., & Joyce, P. R. (2015). Predictors of response to CBT and IPT for depression; The contribution of therapy process. Behaviour Research and Therapy, 74, 72–79. doi:10.1016/j.brat.2015.09.003.CrossRefPubMed

47.

Kupfer, D. J., & Frank, E. (2003). Comorbidity in depression. Acta Psychiatrica Scandinavica, 108, 57–60.CrossRef

48.

Sangha, O., Stucki, G., Liang, M. H., Fossel, A. H., & Katz, J. N. (2003). The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis and Rheumatism, 49(2), 156–163. doi:10.1002/art.10993.CrossRefPubMed

49.

Olomu, A. B., Corser, W. D., Stommel, M., Xie, Y., & Holmes-Rovner, M. (2012). Do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly? BMC Health Services Research, 12, 398. doi:10.1186/1472-6963-12-398.CrossRefPubMedPubMedCentral

50.

Williams, A. D., Blackwell, S. E., Mackenzie, A., Holmes, E. A., & Andrews, G. (2013). Combining imagination and reason in the treatment of depression: a randomized controlled trial of internet-based cognitive-bias modification and internet-CBT for depression. Journal of Consulting and Clinical Psychology, 81(5), 793–799. doi:10.1037/a0033247.CrossRefPubMedPubMedCentral

51.

Crits-Christoph, P., Baranackie, K., Kurcias, J., Beck, A., Carroll, K., Perry, K., et al. (1991). Meta-analysis of therapist effects in psychotherapy outcome studies. Psychotherapy Research, 1(2), 81–91.CrossRef

52.

Crawford, M. J., Robotham, D., Thana, L., Patterson, S., Weaver, T., Barber, R., et al. (2011). Selecting outcome measures in mental health: The views of service users. Journal of Mental Health, 20(4), 336–346. doi:10.3109/09638237.2011.577114.CrossRefPubMed

53.

Gilbody, S., Richards, D., Brealey, S., & Hewitt, C. (2007). Screening for depression in medical settings with the Patient Health Questionnaire (PHQ): a diagnostic meta-analysis. Journal of General Internal Medicine, 22(11), 1596–1602. doi:10.1007/s11606-007-0333-y.CrossRefPubMedPubMedCentral

54.

Reise, S. P., & Rodriguez, A. (2016). Item response theory and the measurement of psychiatric constructs: some empirical and conceptual issues and challenges. Psychological Medicine, 46(10), 2025–2039. doi:10.1017/S0033291716000520.CrossRefPubMed

55.

Kolen, M. J., & Brennan, R. L. (2014). Test equating, scaling, and linking. New York: Springer.CrossRef

56.

Fischer, H. F., Klug, C., Roeper, K., Blozik, E., Edelmann, F., Eisele, M., et al. (2014). Screening for mental disorders in heart failure patients using computer-adaptive tests. Quality of Life Research, 23(5), 1609–1618. doi:10.1007/s11136-013-0599-y.CrossRefPubMed

57.

Knapp, M. (2013). Making an economic case for better mental health services. In G. Thornicroft, M. Ruggeri, & D. Goldberg (Eds.), Improving mental health care, the global challenge (pp. 193–200). Oxford: Wiley-Blackwell.CrossRef

58.

Garcia-Campayo, J., Zamorano, E., Ruiz, M. A., Pardo, A., Perez-Paramo, M., Lopez-Gomez, V., et al. (2010). Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool. Health Qual Life Outcomes, 8, 8. doi:10.1186/1477-7525-8-8.CrossRefPubMedPubMedCentral

59.

Gelaye, B., Williams, M. A., Lemma, S., Deyessa, N., Bahretibeb, Y., Shibre, T., et al. (2013). Validity of the Patient Health Questionnaire-9 for depression screening and diagnosis in East Africa. Psychiatry Research, 210(2), 653–661. doi:10.1016/j.psychres.2013.07.015.CrossRefPubMed

60.

Zhong, Q., Gelaye, B., Fann, J. R., Sanchez, S. E., & Williams, M. A. (2014). Cross-cultural validity of the Spanish version of PHQ-9 among pregnant Peruvian women: A Rasch item response theory analysis. Journal of Affective Disorders, 158, 148–153. doi:10.1016/j.jad.2014.02.012.CrossRefPubMedPubMedCentral

61.

Silveira, C., Parpinelli, M. A., Pacagnella, R. C., Camargo, R. S., Costa, M. L., Zanardi, D. M., et al. (2013). Cross-cultural adaptation of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) into Portuguese. Revista Da Associacao Medica Brasileira, 59(3), 234–240. doi:10.1016/j.ramb.2012.11.005.CrossRefPubMed

62.

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of general internal medicine., 16(9), 606–613.CrossRefPubMedPubMedCentral

63.

Chwastiak, L. A., & Von Korff, M. (2003). Disability in depression and back pain: Evaluation of the World Health Organization Disability Assessment Schedule (WHO DAS II) in a primary care setting. Journal of clinical epidemiology., 56(6), 507–514.CrossRefPubMed

Title: Standardization of health outcomes assessment for depression and anxiety: recommendations from the ICHOM Depression and Anxiety Working Group
Authors: 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
Dave Smithson
Caleb Stowell
Kelly Woolaway-Bickel
Matthias Rose
Publication date: 01-12-2017
Publisher: Springer International Publishing
Published in: Quality of Life Research / Issue 12/2017
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-017-1659-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Standardization of health outcomes assessment for depression and anxiety: recommendations from the ICHOM Depression and Anxiety Working Group

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 12/2017

Perceived discrimination and health-related quality-of-life: gender differences among older African Americans

Do male esophageal cancer patients have impaired sexual function after esophagectomy? A self-reported outcomes study

Differences in quality of life between Jewish and Arab patients on hemodialysis

The role of dual diagnosis in health-related quality of life among treatment-seeking patients in Spain

Associations between health-related quality of life, cardiorespiratory fitness, muscle strength, physical activity and waist circumference in 10-year-old children: the ASK study

Feasibility, comparability, and reliability of the standard gamble compared with the rating scale and time trade-off techniques in Korean population