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Swedish Association of Child and Adolescent Psychiatry Annual meeting, Lund, 2 nd April 2008 Making life easier for our

Swedish Association of Child and Adolescent Psychiatry Annual meeting, Lund, 2 nd April 2008 Making life easier for ourselves and families: Using the online DAWBA in Swedish to take some of the hard work out of detailed assessments Robert Goodman

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Swedish Association of Child and Adolescent Psychiatry Annual meeting, Lund, 2 nd April 2008 Making life easier for our

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  1. Swedish Association of Child and Adolescent Psychiatry Annual meeting, Lund, 2nd April 2008 Making life easier for ourselves and families: Using the online DAWBA in Swedish to take some of the hard work out of detailed assessments Robert Goodman King’s College London Institute of Psychiatry

  2. Motivated and courteous staff 2) Thorough assessment of psychopathology and risk factors Starting from first principles Key ingredients of effective clinical work: 3)Evidence based treatment 4) Routine monitoring of outcome

  3. 5) Maximize cost-benefit ratio 6) Easy access to all potential beneficiaries Additional principles from public health

  4. The use of machines can greatly increase the productivity of workers In the long run this: 1) Increases wages 2) Makes products and services cheaper and therefore more widely available Automation

  5. Spinning

  6. Harvesting

  7. Washing clothes

  8. Adding up numbers

  9. Medical investigations

  10. Thorough assessment of psychopathology and risk factors There are several options: • Questionnaires and fully structured interviews • Semi-structured interviews • Hybrid measures

  11. Questionnaires and fully structured interviews (respondent-based) The questions and response categories are fixed. These can be administered by a computer or an interviewer, but the interviewer’s job is really just to read the question, and not to modify the question or interpret the response. e.g. the DISC

  12. Semi-structured interviews (investigator-based) A highly trained interviewer uses flexible questioning to decide if each of the relevant symptoms is present or not. e.g. CAPA, K-SADS

  13. Fully structured Semi-structured Quick + Cheap + Clinically convincing ++ +

  14. For many fully and semi-structured interviews: Answers to the interview Final diagnoses Fully automatic computer algorithm

  15. Development and Well-Being Assessment (DAWBA) • Computer or non-specialist interviewer administers two sorts of questions: • Fixed questions with fixed response options • 2) Open-ended follow-on questions to elicit descriptions of problems in the respondents’ own words

  16. Additional clinical interview Answers to fixed question Computer algorithm Provisional diagnosis Experienced clinical rater makes final diagnoses Summaries Answers to open-ended questions 10,000 : 300 : 3

  17. The DAWBA clinical raters deal with 3 key questions: 1) Did the respondents understand the questions? 2) How should conflicting information be resolved? 3) Assign a non-operationalised diagnosis?

  18. The validity of the DAWBA has been demonstrated in British, Brazilian, Bangladeshi and Yemeni studies. In addition: • It generates sensible results for prevalence and risk factors • It is relatively quick and easy • It works in difficult circumstances

  19. The DAWBA in Swedish With particular thanks to : Jan-Olov Larrson Hans Smedje

  20. www.dawba.com for a demonstration of the online DAWBA system

  21. To register your team for a free trial of the online DAWBA system: www.dawba.net/user Or email us with questions: dawba@www.youthinmind.net

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