Ventura J, Liberman R P, Green M F, Shaner A, Mintz J
Intervention Research Center for Major Mental Illness (116AR), West Los Angeles VA Medical Center, CA 90073, USA.
Psychiatry Res. 1998 Jun 15;79(2):163-73. doi: 10.1016/s0165-1781(98)00038-9.
Accuracy in psychiatric diagnosis is critical for evaluating the suitability of the subjects for entry into research protocols and for establishing comparability of findings across study sites. However, training programs in the use of diagnostic instruments for research projects are not well systematized. Furthermore, little information has been published on the maintenance of interrater reliability of diagnostic assessments. At the UCLA Research Center for Major Mental Illnesses, a Training and Quality Assurance Program for SCID interviewers was used to evaluate interrater reliability and diagnostic accuracy. Although clinically experienced interviewers achieved better interrater reliability and overall diagnostic accuracy than neophyte interviewers, both groups were able to achieve and maintain high levels of interrater reliability, diagnostic accuracy, and interviewer skill. At the first quality assurance check after training, there were no significant differences between experienced and neophyte interviewers in interrater reliability or diagnostic accuracy. Standardization of training and quality assurance procedures within and across research projects may make research findings from study sites more comparable.
精神病诊断的准确性对于评估受试者进入研究方案的适用性以及在各研究地点建立研究结果的可比性至关重要。然而,针对研究项目使用诊断工具的培训项目并未得到很好的系统化。此外,关于维持诊断评估的评分者间信度的信息鲜有发表。在加州大学洛杉矶分校严重精神疾病研究中心,一项针对SCID访谈者的培训与质量保证项目被用于评估评分者间信度和诊断准确性。尽管有临床经验的访谈者在评分者间信度和总体诊断准确性方面比新手访谈者表现更好,但两组都能够达到并维持较高水平的评分者间信度、诊断准确性和访谈者技能。在培训后的首次质量保证检查中,经验丰富的访谈者和新手访谈者在评分者间信度或诊断准确性方面没有显著差异。研究项目内部和之间培训与质量保证程序的标准化可能会使各研究地点的研究结果更具可比性。