P. Brann et al., Routine outcome measurement in a child and adolescent mental health service: an evaluation of HoNOSCA, AUST NZ J P, 35(3), 2001, pp. 370-376
Objective: This paper evaluates a range of properties for a clinician-based
instrument designed for routine use in a child and adolescent mental healt
h service (CAMHS).
Method: The Health of the Nation Outcome Scales for Children and Adolescent
s (HoNOSCA) is a new outcome measure with great promise. Case vignettes wer
e used to examine interrater reliability. HoNOSCA was implemented for routi
ne outpatient use by multidisciplinary staff with a return rate of 84%. The
305 ratings obtained at assessment were analysed by age, gender and diagno
sis. A sample of 145 paired ratings with a 3-month interval were examined f
or the measurement of change over time.
Results: Interrater reliability of the total score indicates moderate relia
bility if absolute scores are used and good reliability if the total score
is used for relative comparisons. Most scales have good to very good reliab
ility. The scales discriminated between age and gender in the expected way.
HoNOSCA correlated with clinicians' views of change and was sensitive to c
hange over a 3-month period. The total score seemed a proxy for severity.
Conclusion: Routine outcome instruments must be explored in settings where
they will be used and with realistic training. HoNOSCA appears to be of val
ue in routine outcome measurement and although questions remain about relia
bility and validity, the results strongly support further investigation.