Kumar Mrityunjai, Sawhney Indermeet, Chester Verity, Alexander Regi, Mitchell James, Shankar Rohit
St Helens and Knowsley Teaching Hospitals NHS Trust, Saint Helens, UK.
Hertfordshire Partnership University NHS Foundation Trust Hatfield, Hatfield, Hertfordshire, UK.
Int J Soc Psychiatry. 2025 Mar;71(2):239-253. doi: 10.1177/00207640241291517. Epub 2024 Oct 25.
Outcome measurement is essential to determine the effectiveness of health interventions and improve the quality of services. The interplay of social, individual, and biological factors makes this a complex process in the psychiatry of people with intellectual disability (PwID).
Review of outcome measures which are validated in PwID.
A PRISMA-guided review was conducted, using a predefined criteria and a relevant word combination on four databases: EMBASE, Medline, CINAHL and PsycINFO. Each included study was examined for relevance to intellectual disability psychiatry. The psychometric data of each tool was critically assessed. Findings were narratively synthesised.
Of 1,548 articles, 35 met the inclusion criteria. Several outcome measures were identified relevant to intellectual disability psychiatry, including tools for challenging/offending behavior, specific neurodevelopmental/clinical conditions such as ADHD, epilepsy, and dementia however, psychometric properties, validity and reliability varied considerably. The tools identified were largely clinician rated, with a dearth of measures suitable for completion by patients or their family carers.
Most outcome measures used for PwID lack suitable psychometric properties including validity or reliability for use within the ID population. Of importance, those with alternative expression or are non-verbal have been excluded from the research developing and reporting on measurement instruments. There is an underserved population who risk being left behind in the era of value-based medicine and increasing use of outcome measurement when assessing the effectiveness of healthcare interventions on individual and population levels. This is the first of its kind review in this area.
结果测量对于确定健康干预措施的有效性和提高服务质量至关重要。社会、个体和生物因素的相互作用使得这在智障人士（PwID）的精神病学中成为一个复杂的过程。
综述在智障人士中得到验证的结果测量方法。
采用PRISMA指南进行综述，在四个数据库（EMBASE、Medline、CINAHL和PsycINFO）上使用预定义标准和相关词汇组合。对每项纳入研究进行检查，看其是否与智障人士精神病学相关。对每个工具的心理测量数据进行严格评估。研究结果进行叙述性综合。
在1548篇文章中，35篇符合纳入标准。确定了几种与智障人士精神病学相关的结果测量方法，包括用于挑战性行为/攻击性行为的工具，以及针对特定神经发育/临床状况（如注意力缺陷多动障碍、癫痫和痴呆）的工具。然而，心理测量特性、有效性和可靠性差异很大。所确定的工具大多由临床医生评定，缺乏适合患者或其家庭护理人员完成的测量方法。
用于智障人士的大多数结果测量方法缺乏合适的心理测量特性，包括在智障人群中使用的有效性或可靠性。重要的是，那些有替代表达方式或非言语的方法在测量工具的开发和报告研究中被排除在外。在基于价值的医学时代以及在评估医疗保健干预措施对个体和人群水平的有效性时越来越多地使用结果测量的情况下，有一部分人群未得到充分服务，面临被落下的风险。这是该领域同类综述中的第一篇。
