Forensic Services, Adult Mental Health Division, State of Hawaii, Courts and Corrections Branch, Honolulu, HI 96817, USA.
Law Hum Behav. 2012 Apr;36(2):130-9. doi: 10.1037/h0093958.
Despite many studies that examine the reliability of competence to stand trial (CST) evaluations, few shed light on "field reliability," or agreement among forensic evaluators in routine practice. We reviewed 216 cases from Hawaii, which requires three separate evaluations from independent clinicians for each felony defendant referred for CST evaluation. Results revealed moderate agreement. In 71% of initial CST evaluations, all evaluators agreed about a defendant's competence or incompetence (kappa = .65). Agreement was somewhat lower (61%, kappa = .57) in re-evaluations of defendants who were originally found incompetent and sent for restoration services. We also examined the decisions judges made about a defendant's CST. When evaluators disagreed, judges tended to make decisions consistent with the majority opinion. But when judges disagreed with the majority opinion, they more often did so to find a defendant incompetent than competent, suggesting a generally conservative approach. Overall, results reveal moderate agreement among independent evaluators in routine practice. But we discuss the potential for standardized training and methodology to further improve the field reliability of CST evaluations.
尽管有许多研究检查了审判能力（CST）评估的可靠性，但很少有研究能阐明“现场可靠性”，即常规实践中法医评估者之间的一致性。我们审查了来自夏威夷的 216 个案例，该州要求对每个被转介进行 CST 评估的重罪被告进行三次独立临床医生的单独评估。结果显示出中等程度的一致性。在 71%的初始 CST 评估中，所有评估者都同意被告是否具有能力或无能力（kappa =.65）。对于最初被认定为无能力并被送往恢复服务的被告的重新评估，一致性略低（61%，kappa =.57）。我们还研究了法官对被告 CST 的决定。当评估者意见不一致时，法官倾向于做出与多数意见一致的决定。但是，当法官与多数意见不一致时，他们更倾向于认定被告无能力，而不是有能力，这表明法官通常采取保守的态度。总的来说，结果显示在常规实践中，独立评估者之间存在中等程度的一致性。但我们讨论了标准化培训和方法的潜力，以进一步提高 CST 评估的现场可靠性。
