改良版临床总体印象量表（iCGI）：在抑郁症中的开发与验证
The improved Clinical Global Impression Scale (iCGI): development and validation in depression.
作者信息
Kadouri Alane, Corruble Emmanuelle, Falissard Bruno
机构信息
Inserm, U669, Paris, France.
出版信息
BMC Psychiatry. 2007 Feb 6;7:7. doi: 10.1186/1471-244X-7-7.
BACKGROUND
The Clinical Global Impression scale (CGI) is frequently used in medical care and clinical research because of its face validity and practicability. This study proposes to improve the reliability of the Clinical Global Impression (CGI) scale in depressive disorders by the use of a semi-standardized interview, a new response format, and a Delphi procedure.
METHODS
Thirty patients hospitalised for a major depressive episode were filmed at T1 (first week in hospital) and at T2 (2 weeks later) during a 5' specific interview. The Hamilton Depressive Rating Scale and the Symptom Check List were also rated. Eleven psychiatrists rated these videos using either the usual CGI response format or an improved response format, with or without a Delphi procedure.
RESULTS
The new response format slightly improved (but not significantly) the interrater agreement, the Delphi procedure did not. The best results were obtained when ratings by 4 independent raters were averaged. In this situation, intraclass correlation coefficients were about 0.9.
CONCLUSION
The Clinical Global Impression is a useful approach in psychiatry since it apprehends patients in their entirety. This study shows that it is possible to quantify such impressions with a high level of interrater agreement.
背景
临床总体印象量表（CGI）因其表面效度和实用性，在医疗保健及临床研究中被广泛使用。本研究旨在通过采用半标准化访谈、新的反应格式和德尔菲法，提高临床总体印象（CGI）量表在抑郁症中的信度。
方法
对30例因重度抑郁发作住院的患者，在T1（住院第一周）和T2（两周后）进行5分钟的特定访谈，并拍摄下来。同时对汉密尔顿抑郁量表和症状自评量表进行评分。11位精神科医生使用常规CGI反应格式或改进后的反应格式，对这些视频进行评分，评分过程中有或没有采用德尔菲法。
结果
新的反应格式使评分者间的一致性略有提高（但不显著），德尔菲法未起到这种作用。当对4位独立评分者的评分进行平均时，得到了最佳结果。在这种情况下，组内相关系数约为0.9。
结论
临床总体印象是精神病学中一种有用的方法, 因为它能全面地了解患者。本研究表明，有可能以高度的评分者间一致性对这些印象进行量化。
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