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

Bibliographic Data

ID19507619
AuthorsJohn F P Bridges (0000-0002-3082-5535, Johns Hopkins University, corresponding author), Lara Slawik (Janssen (Germany)), Annette Schmeding, Jens Reimer (0009-0007-5406-5319, Marymount University), Dieter Naber (Marymount University), Olaf Kuhnigk (Universität Hamburg)
Year2013
Volume16
Issue2
Pages164-176
Publication date2013-06-01
Open AccessYes
TypeARTICLE
VenueHealth Expectations (JOURNAL)
Journal identifiersISSN: 1369-6513 • E-ISSN: 1369-7625
PublisherWiley (PUBLISHER • GB)
DOI10.1111/j.1369-7625.2011.00704.x
PMID21668795
OpenAlexW1803486871
LanguageEN
Citations received5
References cited47

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 (ρ = 0.63; P = 0.002), ranking (ρ = 0.51; P = 0.02) and self‐explicated methods (ρ = 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 Conclusions While there is an overall concordance between patients’ and psychiatrists’ valuation, significantly different valuations on specific goals can be identified. Here, psychiatrists tend to focus on ‘textbook’ outcomes, while patients are more concerned with functioning and living a normal life. This study also demonstrates the importance of comparing the concordance in treatment goals and the importance of preference‐based methods, such as the self‐explicated method, in the study of concordance

Concordance · Developmental psychology · Likert scale · Ordinal data · Psychiatry · Rating scale · Statistic · Statistics · Clinical Psychology · Healthcare Decision-Making and Restraints · Mathematics · Medicine · Patient-Provider Communication in Healthcare · Psychology · Schizophrenia research and treatment · Internal Medicine

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