Repeated measurement of outcomes during ordinary clinical care. It can reveal trajectories, deterioration and lack of progress; an additional design is required to establish that acting on the information improves outcomes.
The proportion of a clearly specified clinical population with usable outcome measurements. High coverage among treated patients does not establish coverage among all referrals, all people needing care or a common long-term endpoint.
Providing clinicians or patients with interpretable progress information, sometimes including alerts for trajectories at risk of poor outcome. A trial of feedback linked to supervisory action tests that arrangement, rather than measurement in isolation.[ref]
Feedback-informed treatment versus usual psychological treatment for depression and anxiety: a multisite, open-label, cluster randomised controlled trial by Jaime Delgadillo and others. Lancet Psychiatry 5, 564–572; 77 participating therapists, 2233 patients, cluster allocation and not-on-track outcomes
A trajectory classified by a specified rule as unlikely to reach an expected outcome. An alert should prompt clinical review; its validity, false alarms and feasible responses require evaluation.
Obtaining outcome measures at successive attended sessions. It can supply a last available score when a planned final contact is missed, while differing endpoint timing and people who never enter treatment remain important limitations.[ref]
Improving access to psychological therapy: Initial evaluation of two UK demonstration sites by David M. Clark and others. Behaviour Research and Therapy 47, 910–920; Doncaster and Newham prospective service cohorts, sessional monitoring and ten-month follow-up
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