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Comparing clinical risk assessments using operationalized criteria.

C S H Brown·K R Lloyd
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Abstract

OBJECTIVE: To compare the clinical risk assessment of patients by psychiatrists working in different mental health service settings (low, medium and high security). METHOD: Operationalized criteria of clinical factors recognized as indicating risk of harm to others were developed into a simple checklist with explicit item descriptions and definitions (OP-RISK). This was used to compare risk assessments in a prospective cohort of 161 consecutive referrals to a high secure psychiatric hospital. RESULTS: Agreement on the risk posed by a patient between psychiatrists working outside and inside high secure services using unstructured clinical risk assessment was poor (kappa=-0.006). When OP-RISK was applied to the clinical risk assessments, agreement improved (kappa=0.742). CONCLUSION: Applying operationalized criteria to clinical risk assessment is useful in integrating different mental health service settings. The use of OP-RISK may facilitate the referral process to tertiary care.

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Cohort StudiesHospitalizationHospitals, PsychiatricHumansMental DisordersPredictive Value of TestsProspective StudiesROC CurveRisk FactorsSeverity of Illness IndexSocial Behavior DisordersSurveys and QuestionnairesViolenceComparative StudyJournal Article

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C S H Brown, K R Lloyd. 2002. Comparing clinical risk assessments using operationalized criteria.. https://doi.org/10.1034/j.1600-0447.106.s412.32.x

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