Eisen Susan V, Normand Sharon-Lise, Belanger Albert J, Spiro Avron, Esch David
Center for Health Quality Outcomes and Economics Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts, USA.
Med Care. 2004 Dec;42(12):1230-41. doi: 10.1097/00005650-200412000-00010.
To assess outcomes of health services, providers need brief, responsive, reliable, and valid measures that can be implemented in clinical settings with minimal cost and burden. The Behavior and Symptom Identification Scale (BASIS-32) is a self-report measure developed in 1984 to assess mental health treatment outcomes. During the past 3 years, multiple methods were used to revise the instrument to improve reliability, validity, and applicability to diverse groups of mental health service recipients.
The objective of this study was to field test the revised instrument, make further changes based on analysis of the field test data, and assess reliability and validity of the final version (BASIS-24).
A field test was implemented at 27 treatment sites across the United States. A total of 2656 inpatients and 3222 outpatients participated. Factor analytic methods, classic test theory, and item response theory modeling were used to select the most discriminating, nonredundant items for inclusion in the final version of the instrument and to assess its reliability and validity. Item response theory modeling was used to score the instrument.
The final instrument includes 24 items assessing 6 domains: depression/ functioning, interpersonal relationships, self-harm, emotional lability, psychosis, and substance abuse. Test-retest and internal consistency reliability were acceptable. Tests of construct and discriminant validity supported the instrument's ability to discriminate groups expected to differ in mental health status, and its correlation with other measures of mental health.
Analyses of the BASIS-24 supported its reliability and validity for assessing mental health status from the patient's perspective.
为评估卫生服务的效果，提供者需要简短、灵敏、可靠且有效的测量方法，这些方法应能在临床环境中以最小的成本和负担实施。行为与症状识别量表（BASIS - 32）是1984年开发的一种自评量表，用于评估心理健康治疗效果。在过去3年中，采用了多种方法对该工具进行修订，以提高其可靠性、有效性以及对不同心理健康服务接受者群体的适用性。
本研究的目的是对修订后的工具进行现场测试，根据现场测试数据分析结果进一步修改，并评估最终版本（BASIS - 24）的可靠性和有效性。
在美国27个治疗地点进行了现场测试。共有2656名住院患者和3222名门诊患者参与。采用因素分析方法、经典测试理论和项目反应理论模型来选择最具区分性、非冗余的项目纳入工具的最终版本，并评估其可靠性和有效性。使用项目反应理论模型对该工具进行评分。
最终工具包括24个项目，评估6个领域：抑郁/功能、人际关系、自我伤害、情绪不稳定、精神病和药物滥用。重测信度和内部一致性信度均可接受。结构效度和区分效度测试支持该工具区分预期心理健康状况不同群体的能力，以及它与其他心理健康测量方法的相关性。
对BASIS - 24的分析支持其从患者角度评估心理健康状况的可靠性和有效性。
