Inter Clinician Reliability of Clinical Assessments

Background

  • We live in a time where mental health disorders rank as the top contributors to the global burden of disease, and the age groups affected by these disorders are skewing increasingly younger.
  • We also know that despite the availability of many clinical assessments, the diagnosis of mental health illnesses is imperfect, varying substantially across clinical practitioners

Research Question

  • What is the inter-clinician reliability of standard diagnostic assessments?
    • In other words, if 10 clinicians use the same clinical questionnaire to diagnose a child/adolescent with a mental health disorder, how reliable is that diagnosis?

Method

  • Perform a literature review to identify the inter-clinician reliability of a set of commonly used questionnaires available here
  • These questionnaires are administered as part of the Healthy Brain Network Initiative launched by the Child Mind Institute

Overview of Questionnaires

  • Healthy brains

  • The Child Mind Institute has launched the Healthy Brain Network, an ongoing initiative focused on creating and sharing a biobank comprised of data from 10,000 New York City area children and adolescents (ages 5-21).

  • Population: ages 5-21, children who likely have one or more psychiatric symptoms

  • Data collected:

    • MRI + fMRI: movies (~10 min), predictive eye estimation regression - 3444 participants
    • Diagnostic Assessment
    • Physical activity
    • Behavioral measures (questionnaires)
    • Family structures (stress, trauma)
    • Substance use/addiction
    • Cognition and language tasks
    • Disorder-specific questionnaires
    • Electroencephalography
    • Digital Voice and Video Recordings
    • Genetics
    • Actigraphy
    • Cognitive Tasks (e.g., sequence learning), naturalistic stimuli
    • Eyetracking: pupil dilation and eye position

Phenotypic Assessment Protocol

Results

  • What criteria/metrics are used to assess reliability?
  • Are certain questionnaires more reliable than others?
  • Why are certain questionnaires more/less reliable than others?

Conclusion

  • What inference can we make about diagnostic assessment based on the results of this review?