Section of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Psychiatry Res. 2010 May 15;177(1-2):206-10. doi: 10.1016/j.psychres.2010.02.006. Epub 2010 Mar 23.
The Children's Global Assessment Scale (CGAS) is a tool to assess the overall level of functioning of children in Child and Adolescent Mental Health Services (CAMHS). Even though the use of this rating scale requires trained raters, it is commonly deployed without prior training in clinical settings. The aim of this study was to investigate the reliability and the agreement of CGAS ratings with an expert rating, in a clinical setting with untrained raters. Five experienced clinicians rated five vignettes to provide expert ratings. These vignettes were then rated by 703 health-care professionals representing 33 Swedish CAMHS. The health-care professionals rated the vignettes significantly higher (showing better global functioning) than the expert ratings. There was a wide range between the minimum and maximum ratings. The intraclass correlation coefficient was 0.73, which indicates moderate inter-rater reliability. Neither clinical experience nor earlier experience of using CGAS influenced the agreement with the expert ratings. The inter-rater reliability is moderate when CGAS is used in a clinical setting with untrained raters. Further, the untrained raters differed substantially from the experts. This stresses the importance of proper training in conjunction with the introduction of new rating scales.
儿童全球评估量表 (CGAS) 是一种用于评估儿童和青少年心理健康服务 (CAMHS) 中儿童整体功能水平的工具。尽管使用这种评分量表需要经过培训的评分者，但在临床环境中，它常常未经培训就被使用。本研究旨在调查在未经培训的评分者的临床环境中，CGAS 评分与专家评分的可靠性和一致性。五位经验丰富的临床医生对五个病例进行评分，以提供专家评分。然后，这些病例由代表瑞典 33 个 CAMHS 的 703 名医疗保健专业人员进行评分。医疗保健专业人员对病例的评分明显高于专家评分（表现出更好的整体功能）。评分的最低值和最高值之间有很大的差距。组内相关系数为 0.73，表明评分者之间的可靠性为中等。临床经验和使用 CGAS 的先前经验均未影响与专家评分的一致性。当 CGAS 在未经培训的评分者的临床环境中使用时，评分者之间的可靠性为中等。此外，未经培训的评分者与专家有很大的不同。这强调了在引入新的评分量表时，适当培训的重要性。
