Treatment results for severe psychiatric illness: which method is best suited to denote the outcome of mental health care?

Table 3 Effect Size (ES) and percentage of patients in outcome categories based on raw HoNOS scores and classification according to various ES_medium, SEM, and JT_RCI-90 threshold values, and according to JT_RCI95, JT_CS, and JT_RCI&CS

Institution		1	2	3	4	5	6	7	8	9	10	Total	Rank order^a	Rho
Continuous:	ES	0.06	0.18	0.19	0.24	0.29	0.29	0.32	0.38	0.38	0.39	0.29	1 2 3 4 5/6 7 8/9 10
Categorical:
ES_medium ≤ −4	deteriorated	20.0	19.3	20.5	20.7	15.2	11.4	17.8	14.8	20.9	14.1	17.3	9 4 3 1 2 7 5 8 10 6	.35
-4 < ES_medium < 4	unchanged	56.2	48.4	43.7	40.0	49.7	57.6	45.0	42.7	34.4	46.7	45.9	6 1 5 2 10 7 3 8 4 9	.38
ES_medium ≥ 4	improved	23.8	32.3	35.8	39.3	35.1	31.0	37.2	42.5	44.7	39.2	36.8	1 5 2 8 4 3 6 9 10 7	.71*
SEM ≤ −5	deteriorated	15.5	13.0	15.3	17.6	12.5	9.1	14.5	11.0	16.2	11.1	13.5	4 9 1 3 7 2 5 10 8 6	.35
-5 < SEM < 5	unchanged	63.4	60.4	56.3	49.3	57.1	68.1	53.7	52.7	45.9	54.8	55.5	6 1 2 5 3 10 7 8 4 9	.55
SEM ≥ 5	improved	21.1	26.6	28.4	33.1	30.4	22.8	31.9	36.3	37.8	34.2	30.9	1 6 2 3 5 7 4 10 8 9	.79**
JT_RCI90 ≤ −9	deteriorated	8.3	4.2	7.0	9.3	3.6	2.3	5.1	3.9	7.6	2.5	5.4	4 1 9 3 7 2 8 5 10 6	.43
9 < JT_RCI90 < 9	unchanged	85.3	82.8	80.0	71.4	87.5	88.0	82.2	79.2	69.0	83.9	80.6	6 5 1 10 2 7 3 8 4 9	.24
JT_RCI90 ≥ 9	improved	6.4	13.0	13.0	19.3	8.9	9.6	12.7	16.9	23.3	13.6	14.1	1 5 6 7 2/3 10 8 4 9	.51
JT_RCI (change ≥8)	reliable change	9.4	14.6	14.9	19.7	11.3	14.3	17.4	21.7	27.0	15.6	17.3	1 5 6 2 3 10 7 4 8 9	.64*
JT_CS (post < 5)	clinical change	13.6	9.9	7.0	7.2	8.6	14.9	16.0	15.5	15.2	21.1	13.3	3 4 5 2 10 1 6 8 7 9	.56
JT_RCI&CS	deteriorated	9.1	5.2	8.4	10.3	3.9	3.8	5.9	5.7	10.6	4.5	6.7	9 4 1 3 7 8 2 10 5 6	.14
	unchanged	81.5	80.2	76.7	70.0	84.8	81.9	76.6	72.6	62.4	79.9	75.9	5 6 1 2 10 3 7 8 4 9	.39
	improved	4.5	4.7	3.3	4.1	3.0	6.1	6.3	8.7	9.6	8.0	6.1	5 3 4 1 2 6 7 10 8 9	.75*
	recovered	4.9	9.9	11.6	15.5	8.3	8.2	11.1	13.0	17.4	7.5	11.2	1 10 6 5 2 7 3 8 4 9	.24

\( ES=\frac{M_{pretest}-{M}_{posttest}}{SD_{pretest}}; \) \( SEM= SD\times \sqrt{1-{r}_{ii}} \); \( {JT}_{RCI}=\frac{M_{pretest}-{M}_{posttest}}{SEM} \); \( {JT}_{CS}=\frac{SD_{pre}\ast {M}_{post}+{SD}_{post}\ast {M}_{pre}}{SD_{pre}+{SD}_{post}} \)
ES_medium implies a change of at least 4 points; SEM implies 5 points change or more; JT_RCI90 implies 9 points change; JT_RCI90, JT_CS, and JT_RCI&CS imply 8 points change and transgression of a score of 5 from pretest to posttest. Rho is Spearman rank correlation coefficient between the ranking based on an indicator and ranking based on ES (*p < .05; **p < .01)
^aRanked from the worst (1) to the best (10) outcome according to the indicator; categories “unchanged” and “deteriorated” have a reversed rank order: the fewer the patients the better the outcome

ISSN: 1471-244X