Affective Disorders Program, Department of Psychology, University of Bologna, Italy.
J Clin Psychiatry. 2012 Feb;73(2):177-84. doi: 10.4088/JCP.10r06444. Epub 2011 Aug 9.
The aim of this review was to examine the clinical process in psychiatry, with special reference to clinimetrics, a domain concerned with the measurement of clinical phenomena that do not find room in customary taxonomy.
A MEDLINE search from inception to August 2010 was performed for English-language articles using the keywords clinical judgment, clinimetric, staging, comorbidity, sequential treatment, and subclinical symptoms in relation to psychiatric illness. It was supplemented by a manual search of the literature.
Choice of assessment strategies was based on their established or potential incremental increase in clinical information compared to use of diagnostic criteria.
Contributions were evaluated according to the principles of clinimetrics.
Several innovative assessment strategies were identified: the use of diagnostic transfer stations with repeated assessments instead of diagnostic endpoints, subtyping versus integration of different diagnostic categories, staging methods, and broadening of clinical information through macroanalysis and microanalysis. The most representative examples were selected.
Current assessment strategies in psychiatric research do not reflect the sophisticated thinking that underlies clinical decisions in practice. The clinimetric perspective provides an intellectual home for the reproduction and standardization of these clinical intuitions.
本综述旨在考察精神病学的临床过程，特别关注临床计量学，这是一个涉及无法纳入常规分类学的临床现象测量的领域。
对 2010 年 8 月以前的英文文献进行了 MEDLINE 检索，使用的关键词有临床判断、临床计量学、分期、共病、序贯治疗和亚临床症状与精神疾病的关系。并辅以文献的手动检索。
选择评估策略的依据是其与使用诊断标准相比是否能提供更多的临床信息。
根据临床计量学的原则评估各项研究的贡献。
确定了几种创新的评估策略：使用具有重复评估的诊断转移站而不是诊断终点、对不同诊断类别进行分型而不是整合、分期方法以及通过宏观分析和微观分析拓宽临床信息。选择了最具代表性的例子。
目前精神病学研究中的评估策略并没有反映出实践中临床决策背后的复杂思维。临床计量学视角为复制和标准化这些临床直觉提供了一个智力基础。
