总体功能评估（GAF）：现状与前沿知识概述。
Global Assessment of Functioning (GAF): properties and frontier of current knowledge.
机构信息
Department of Research, Vestfold Mental Health Care Trust, Tönsberg, Norway.
出版信息
Ann Gen Psychiatry. 2010 May 7;9:20. doi: 10.1186/1744-859X-9-20.
BACKGROUND
Global Assessment of Functioning (GAF) is well known internationally and widely used for scoring the severity of illness in psychiatry. Problems with GAF show a need for its further development (for example validity and reliability problems). The aim of the present study was to identify gaps in current knowledge about properties of GAF that are of interest for further development. Properties of GAF are defined as characteristic traits or attributes that serve to define GAF (or may have a role to define a future updated GAF).
METHODS
A thorough literature search was conducted.
RESULTS
A number of gaps in knowledge about the properties of GAF were identified: for example, the current GAF has a continuous scale, but is a continuous or categorical scale better? Scoring is not performed by setting a mark directly on a visual scale, but could this improve scoring? Would new anchor points, including key words and examples, improve GAF (anchor points for symptoms, functioning, positive mental health, prognosis, improvement of generic properties, exclusion criteria for scoring in 10-point intervals, and anchor points at the endpoints of the scale)? Is a change in the number of anchor points and their distribution over the total scale important? Could better instructions for scoring within 10-point intervals improve scoring? Internationally, both single and dual scales for GAF are used, but what is the advantage of having separate symptom and functioning scales? Symptom (GAF-S) and functioning (GAF-F) scales should score different dimensions and still be correlated, but what is the best combination of definitions for GAF-S and GAF-F? For GAF with more than two scales there is limited empirical testing, but what is gained or lost by using more than two scales?
CONCLUSIONS
In the history of GAF, its basic properties have undergone limited changes. Problems with GAF may, in part, be due to lack of a research programme testing the effects of different changes in basic properties. Given the widespread use, research-based development of GAF has not been especially strong. Further research could improve GAF.
背景
全球功能评估（GAF）在国际上广为人知，广泛用于评估精神病学中的疾病严重程度。GAF 存在问题，表明需要进一步开发（例如有效性和可靠性问题）。本研究的目的是确定当前关于 GAF 属性的知识差距，这些属性对于进一步开发很重要。GAF 的属性是指用于定义 GAF 的特征或属性（或者可能在定义未来更新的 GAF 方面发挥作用）。
方法
进行了彻底的文献检索。
结果
确定了 GAF 属性知识方面的一些差距：例如，当前的 GAF 具有连续量表，但连续量表还是分类量表更好？评分不是通过直接在视觉量表上设置标记来完成的，但是这可以提高评分吗？新的锚定点，包括关键词和示例，是否会改善 GAF（症状、功能、积极心理健康、预后、一般属性的改善、在 10 点间隔内评分的排除标准以及量表端点的锚定点）？改变锚定点的数量及其在整个量表上的分布是否重要？更好的 10 点间隔内评分说明是否可以提高评分？国际上，GAF 既可以使用单一量表，也可以使用双量表，但单独的症状和功能量表有什么优势？症状（GAF-S）和功能（GAF-F）量表应评分不同维度，且仍相关，但 GAF-S 和 GAF-F 的最佳定义组合是什么？对于具有两个以上量表的 GAF，其经验测试有限，但使用两个以上量表会有什么得失？
结论
在 GAF 的历史中，其基本属性发生了有限的变化。GAF 存在问题，部分原因可能是缺乏测试基本属性不同变化效果的研究计划。鉴于其广泛应用，基于研究的 GAF 开发并不特别强。进一步的研究可以改进 GAF。
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