Lobo A, Huyse F J, Herzog T, Malt U, Opmeer B C
University of Zaragoza, University Hospital, Spain.
J Psychosom Res. 1996 Feb;40(2):143-56. doi: 10.1016/0022-3999(94)00007-7.
This paper describes the development and testing of the Patient Registration Form (PRF), a standardized instrument for the description of patients seen by consultation-liaison (C-L) psychiatrists and psychosomatists in general hospitals, the referral patterns, the C-L interventions and their outcomes. The PRF study is part of a large multi-centre. European investigation on the effectiveness of mental health service delivery, conducted by the European C-L Workgroup for General Hospital Psychiatry and Psychosomatics (ECLW) and performed in the framework of the of the E.C. 4th Medical and Health Research Program. The final version of the PRF consists of 68 items. It was developed by the Program Management Group (PMG) and National Coordinators (NC) after long preparatory studies to assure both face and content validity and pilot testing. Two hundred and twenty consultants, who required 40 hours of training and came from 14 different European countries and 90 different sites, participated in the final reliability study. The PRF was tested in 13 written case histories. A "gold standard' for the correct answers in each item was decided by "consensus ratings' of the PMG and a subsequent 80% agreement by the NCs. A high standard (average kappa (k) > or = 0.70; at least 2/3 of the PRF items, kappa > or = 0.70) was required for the rater to be considered as "reliable' (RR). The consultants considered the PRF both "feasible' and 93.2% of them fulfilled the RR criteria. The calculated rater-"gold standard' reliability was satisfactory: only four PRF items were identified with low agreement coefficients and no biases were observed cross-nationally in the ratings. Given the implications of misclassification for evaluating C-L effectiveness and services, these results are important and the achievement unprecedented.
本文介绍了患者登记表（PRF）的开发与测试情况。PRF是一种标准化工具，用于描述综合医院中会诊-联络（C-L）精神科医生和身心医学专家所诊治的患者情况、转诊模式、C-L干预措施及其结果。PRF研究是欧洲综合医院精神科和身心医学C-L工作组（ECLW）开展的一项大型多中心欧洲调查的一部分，该调查在欧盟第四医疗卫生研究计划框架内进行。PRF的最终版本包含68个项目。它由项目管理组（PMG）和国家协调员（NC）经过长期准备研究后开发，以确保表面效度和内容效度，并进行了预测试。220名顾问参与了最终的信度研究，他们来自14个不同的欧洲国家和90个不同的地点，需要接受40小时的培训。PRF在13份书面病例中进行了测试。每个项目正确答案的“金标准”由PMG的“共识评分”确定，随后NCs达成80%的一致意见。评分者要被视为“可靠”（RR），需达到高标准（平均kappa（k）≥0.70；PRF项目中至少三分之二，kappa≥0.70）。顾问们认为PRF“可行”，其中93.2%的人符合RR标准。计算得出的评分者与“金标准”的信度令人满意：只有四个PRF项目的一致性系数较低，且在各国评分中未观察到偏差。鉴于错误分类对评估C-L有效性和服务的影响，这些结果很重要，且这一成就是前所未有的。
