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The reliability of the community version of the MRC Needs for Care Assessment

Published online by Cambridge University Press:  09 July 2009

A. D. Lesage ,
L. Fournier ,
M. Cyr ,
J. Toupin ,
J. Fabian ,
G. Gaudette ,
C. Vanier ,
P. E. Bebbington  and
C. R. Brewin
A. D. Lesage*
Affiliation:
Centre de recherche Fernand-Seguin, Louis-H. Lafontaine Hospital, Institut Philippe-Pinel, Department of Psychology, University of Montreal and Department of Psychoeducation, University of Sherbrooke, Quebec, Canada; MRC Social Psychiatry Unit, Institute of Psychiatry and Department of Psychology, Royal Holloway, University of London
L. Fournier
Affiliation:
Centre de recherche Fernand-Seguin, Louis-H. Lafontaine Hospital, Institut Philippe-Pinel, Department of Psychology, University of Montreal and Department of Psychoeducation, University of Sherbrooke, Quebec, Canada; MRC Social Psychiatry Unit, Institute of Psychiatry and Department of Psychology, Royal Holloway, University of London
M. Cyr
Affiliation:
Centre de recherche Fernand-Seguin, Louis-H. Lafontaine Hospital, Institut Philippe-Pinel, Department of Psychology, University of Montreal and Department of Psychoeducation, University of Sherbrooke, Quebec, Canada; MRC Social Psychiatry Unit, Institute of Psychiatry and Department of Psychology, Royal Holloway, University of London
J. Toupin
Affiliation:
Centre de recherche Fernand-Seguin, Louis-H. Lafontaine Hospital, Institut Philippe-Pinel, Department of Psychology, University of Montreal and Department of Psychoeducation, University of Sherbrooke, Quebec, Canada; MRC Social Psychiatry Unit, Institute of Psychiatry and Department of Psychology, Royal Holloway, University of London
J. Fabian
Affiliation:
Centre de recherche Fernand-Seguin, Louis-H. Lafontaine Hospital, Institut Philippe-Pinel, Department of Psychology, University of Montreal and Department of Psychoeducation, University of Sherbrooke, Quebec, Canada; MRC Social Psychiatry Unit, Institute of Psychiatry and Department of Psychology, Royal Holloway, University of London
G. Gaudette
Affiliation:
Centre de recherche Fernand-Seguin, Louis-H. Lafontaine Hospital, Institut Philippe-Pinel, Department of Psychology, University of Montreal and Department of Psychoeducation, University of Sherbrooke, Quebec, Canada; MRC Social Psychiatry Unit, Institute of Psychiatry and Department of Psychology, Royal Holloway, University of London
C. Vanier
Affiliation:
Centre de recherche Fernand-Seguin, Louis-H. Lafontaine Hospital, Institut Philippe-Pinel, Department of Psychology, University of Montreal and Department of Psychoeducation, University of Sherbrooke, Quebec, Canada; MRC Social Psychiatry Unit, Institute of Psychiatry and Department of Psychology, Royal Holloway, University of London
P. E. Bebbington
Affiliation:
Centre de recherche Fernand-Seguin, Louis-H. Lafontaine Hospital, Institut Philippe-Pinel, Department of Psychology, University of Montreal and Department of Psychoeducation, University of Sherbrooke, Quebec, Canada; MRC Social Psychiatry Unit, Institute of Psychiatry and Department of Psychology, Royal Holloway, University of London
C. R. Brewin
Affiliation:
Centre de recherche Fernand-Seguin, Louis-H. Lafontaine Hospital, Institut Philippe-Pinel, Department of Psychology, University of Montreal and Department of Psychoeducation, University of Sherbrooke, Quebec, Canada; MRC Social Psychiatry Unit, Institute of Psychiatry and Department of Psychology, Royal Holloway, University of London
*
1Address for correspondence: Dr Alain D. Lesage, Centre de recherche Fernand-Seguin, Louis-H. Lafontaine Hospital, 7331 Hochelaga, Montreal, Quebec, Canada H1N 3V2.
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Synopsis

One hundred and nine adults were screened in the community using the abridged version of the CIDI (CIDIS). The subjects comprised DSM-III-R current cases (N = 48), lifetime cases (N = 31) and non-cases (N = 30). The interviews with the 109 subjects were conducted by one of two pairs of clinicians and videotaped. Each interviewer–pair included a psychiatrist and a clinical psychologist. They rated the community version of the Needs for Care (NFCAS-C) by consensus. The other pair of judges then viewed the video and rated the NFCAS-C independently. The agreement on overall needs was excellent (kappa = 0·75), and very good for four of the seven specific sections (from kappa = 0·61 to 0·81). One section could not be rated because of low prevalence, and agreement was less good for the remaining two sections. Agreement was good on specific interventions (medication, kappa = 0·60; specific psychotherapy, kappa = 0·55), but poor on non-specific interventions. The majority of disagreements were due to differences in clinical judgement rather than to technical errors. A new instruction manual has been produced and should help training as well as stabilizing reliability. In devising reliable and valid instruments based on clinical judgement, a balance must be achieved between enhancing reliability with more precise rules and constraining clinical judgement so tightly that validity is lost.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 2 , March 1996 , pp. 237 - 243
Copyright
Copyright © Cambridge University Press 1996

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References

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