McCusker Paul J
Department of Veterans A fairs, Cumberland, MD 21502, USA.
Int J Offender Ther Comp Criminol. 2007 Dec;51(6):676-85. doi: 10.1177/0306624X07299227. Epub 2007 Jul 5.
The MacArthur Study of Mental Disorder and Violence produced an instrument for classifying hospitalized psychiatric patients according to their risk of behaving violently following discharge. The instrument, Classification of Violence Risk (COVR) has been computerized and is now commercially available to clinicians. A validation study performed by the original researchers showed that when the instrument was applied to a new sample of patients, it demonstrated a considerable reduction in positive predictive power. Potential factors affecting the instrument's accuracy in applied settings are reviewed. It is concluded that, until additional research clarifies uncertainty about the instrument, clinicians would do well to be very cautious in utilizing COVR results to make judgments as to violence risk, particularly when the test results suggest a high risk of future violence.
麦克阿瑟精神障碍与暴力研究开发了一种工具，用于根据出院后暴力行为风险对住院精神科患者进行分类。该工具即暴力风险分类（COVR）已实现计算机化，目前临床医生可通过商业途径获取。原始研究人员进行的一项验证研究表明，当将该工具应用于新的患者样本时，其阳性预测能力大幅下降。本文回顾了在实际应用环境中影响该工具准确性的潜在因素。结论是，在更多研究澄清该工具存在的不确定性之前，临床医生在利用COVR结果判断暴力风险时应极为谨慎，尤其是当测试结果表明未来暴力风险较高时。
