University Hospital Heidelberg, Center for Psychotherapy Research, Heidelberg, Germany.
Clin Psychol Psychother. 2011 Jul-Aug;18(4):331-8. doi: 10.1002/cpp.717. Epub 2010 Sep 2.
Monitoring psychotherapeutic progress requires valid and economic measures to detect change of clinical relevance. We addressed validity and sensitivity to change of the 'Klinisch Psychologisches Diagnosesystem 38' (KPD-38, Clinical Psychological Diagnosis System), an instrument for outcome monitoring and quality assurance.
Data from an inpatient sample (n = 1.377) were used to investigate the concurrent validity, the sensitivity to change, and the criterion validity of the KPD-38 in comparison to the Outcome Questionnaire (OQ-45) and the Brief Symptom Inventory (BSI).
Sensitivity-specificity analyses showed similar sensitivity and higher specificity for the KPD-38 scales compared with the BSI and OQ total scores. Change rates on the KPD-38 distress scale (DIS) were found to be lower than on the BSI (KPD-38 DIS: 36.6%, GSI: 67.7%) and the OQ-45 (KPD-38 DIS: 44.3%, OQ tot: 57.1%) total scores. Concordance was low with the BSI ([κ = 0.24] and moderate with the OQ-45 [κ = 0.45]).
Implications for applications in the field of outcome assessment and the challenge of further validation are discussed. The relation between sensitivity to change and criterion validity is highlighted.
监测心理治疗进展需要有效的和经济的措施来检测具有临床相关性的变化。我们研究了“临床心理诊断系统 38 号”（KPD-38）的有效性和对变化的敏感性，这是一种用于结果监测和质量保证的工具。
使用住院样本（n=1377）的数据，我们调查了 KPD-38 与结果问卷（OQ-45）和简明症状量表（BSI）相比的同时效度、对变化的敏感性和标准效度。
敏感性-特异性分析表明，与 BSI 和 OQ 总分相比，KPD-38 量表具有相似的敏感性和更高的特异性。KPD-38 痛苦量表（DIS）的变化率低于 BSI（KPD-38 DIS：36.6%，GSI：67.7%）和 OQ-45（KPD-38 DIS：44.3%，OQ 总：57.1%）总分。与 BSI 的一致性较低（[κ=0.24]），与 OQ-45 的一致性适中（[κ=0.45]）。
讨论了在结果评估领域的应用的意义和进一步验证的挑战。强调了对变化的敏感性和标准效度之间的关系。
