Evidence-based assessment/Preparation phase

The preparation phase is a great opportunity to work smarter, and not harder. We can think about what are the most common issues among the reasons people come to the clinic, and use that perspective as a way to filter and organize our assessments and actions.

In the preparation phase, we:


 * Identify and plan for the most common issues,
 * Make sure that we have the best cost-effective assessments for them ready to use (and often built into our clinic's core battery), and
 * Benchmark prevalence rates so that we have a sense of what is typical, and whether our local pattern differs in any interesting ways.

Identifying and planning for the most common issues allow us to avoid cognitive heuristics and errors that may cause us to miss out important diagnoses.

Benchmarking prevalence rates allows us to get a sense of how often we are seeing a particular disorder in this setting. Second, by comparing the local estimates to external benchmarks helps us to get a sense of whether we might want to invest in additional assessment methods, or reflect on reasons why our practice might be different from other settings.

Base rates for transdiagnostic comparison
Notes.


 * Table from Hunsley GATW 2nd edition (Youngstrom & Van Meter 2016)
 * (Perou et al., 2013) is epidemeological
 * (Rettew et al., 2009) is derived from an outpatient clinic
 * (Roth & Fonagy, 2005)


 * Epidemiological rates refer to general population, not treatment seeking samples, and so often represent a lower bound of what might be expected at a clinic.
 * DAU= diagnosis as usual
 * SDI= standard diagnostic interview

Annotated bibliography

 * Gray, G. E. (2004). Evidence-based psychiatry. Washington, D.C.: American Psychiatric Publishing, Inc.
 * Meehl, P. E. (1954). Clinical versus statistical prediction: A theoretical analysis and a review of the evidence. Minneapolis, MN: University of Minnesota Press.
 * Straus, S. E., Glasziou, P., Richardson, W. S., & Haynes, R. B. (2011). Evidence-based medicine: How to practice and teach EBM (4th ed.). New York, NY: Churchill Livingstone.