Developing a decision tool to identify patients with personality disorders in need of highly specialized care

M. Goorden, E.M.C. Willemsen, C.A.M. Bouwmans-Frijters, J.J.V. Busschbach, M.J. Noomx, C.M. van der Feltz-Cornelis, C.A. Uyl-De Groot, L. Hakkaart-van Roijen

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Abstract

Background:
Current guidelines recommend referral to highly specialized care for patients with severe personality disorders. However, criteria for allocation to highly specialized care are not clearly defined. The aim of the present
study was to develop a decision tool that can support clinicians to identify patients with a personality disorder in need of highly specialized care.
Methods:
Steps taken to develop a decision tool were a literature search, concept mapping, a meeting with experts and a validation study.
Results:
The concept mapping method resulted in six criteria for the decision tool. The model used in concept mapping provided a good fit (stress value = 0.30) and reasonable reliability (ρ = 0.49). The bridging values were low, indicating homogeneity. The decision tool was subsequently validated by enrolling 368 patients from seven centers. A multilevel model with a Receiver Operating Characteristic Curve (ROC) was applied. In this way, an easily implementable decision tool with relatively high sensitivity (0.74) and specificity (0.69) was developed.
Conclusions:
A decision tool to identify patients with personality disorders for highly specialized care was developed using advanced methods to combine the input of experts with currently available scientific knowledge. The tool appeared to be able to accurately identify this group of patients. Clinicians can use this decision tool to identify patients who are in need of highly specialized treatment.
Original languageEnglish
Article number317
JournalBMC Psychiatry
Volume17
DOIs
Publication statusPublished - 2017

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Goorden, M., Willemsen, E. M. C., Bouwmans-Frijters, C. A. M., Busschbach, J. J. V., Noomx, M. J., van der Feltz-Cornelis, C. M., ... Hakkaart-van Roijen, L. (2017). Developing a decision tool to identify patients with personality disorders in need of highly specialized care. BMC Psychiatry, 17, [317]. https://doi.org/10.1186/s12888-017-1460-6
Goorden, M. ; Willemsen, E.M.C. ; Bouwmans-Frijters, C.A.M. ; Busschbach, J.J.V. ; Noomx, M.J. ; van der Feltz-Cornelis, C.M. ; Uyl-De Groot, C.A. ; Hakkaart-van Roijen, L. / Developing a decision tool to identify patients with personality disorders in need of highly specialized care. In: BMC Psychiatry. 2017 ; Vol. 17.
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abstract = "Background: Current guidelines recommend referral to highly specialized care for patients with severe personality disorders. However, criteria for allocation to highly specialized care are not clearly defined. The aim of the presentstudy was to develop a decision tool that can support clinicians to identify patients with a personality disorder in need of highly specialized care.Methods: Steps taken to develop a decision tool were a literature search, concept mapping, a meeting with experts and a validation study.Results: The concept mapping method resulted in six criteria for the decision tool. The model used in concept mapping provided a good fit (stress value = 0.30) and reasonable reliability (ρ = 0.49). The bridging values were low, indicating homogeneity. The decision tool was subsequently validated by enrolling 368 patients from seven centers. A multilevel model with a Receiver Operating Characteristic Curve (ROC) was applied. In this way, an easily implementable decision tool with relatively high sensitivity (0.74) and specificity (0.69) was developed.Conclusions: A decision tool to identify patients with personality disorders for highly specialized care was developed using advanced methods to combine the input of experts with currently available scientific knowledge. The tool appeared to be able to accurately identify this group of patients. Clinicians can use this decision tool to identify patients who are in need of highly specialized treatment.",
author = "M. Goorden and E.M.C. Willemsen and C.A.M. Bouwmans-Frijters and J.J.V. Busschbach and M.J. Noomx and {van der Feltz-Cornelis}, C.M. and {Uyl-De Groot}, C.A. and {Hakkaart-van Roijen}, L.",
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Goorden, M, Willemsen, EMC, Bouwmans-Frijters, CAM, Busschbach, JJV, Noomx, MJ, van der Feltz-Cornelis, CM, Uyl-De Groot, CA & Hakkaart-van Roijen, L 2017, 'Developing a decision tool to identify patients with personality disorders in need of highly specialized care', BMC Psychiatry, vol. 17, 317. https://doi.org/10.1186/s12888-017-1460-6

Developing a decision tool to identify patients with personality disorders in need of highly specialized care. / Goorden, M.; Willemsen, E.M.C.; Bouwmans-Frijters, C.A.M.; Busschbach, J.J.V.; Noomx, M.J.; van der Feltz-Cornelis, C.M.; Uyl-De Groot, C.A.; Hakkaart-van Roijen, L.

In: BMC Psychiatry, Vol. 17, 317, 2017.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Developing a decision tool to identify patients with personality disorders in need of highly specialized care

AU - Goorden, M.

AU - Willemsen, E.M.C.

AU - Bouwmans-Frijters, C.A.M.

AU - Busschbach, J.J.V.

AU - Noomx, M.J.

AU - van der Feltz-Cornelis, C.M.

AU - Uyl-De Groot, C.A.

AU - Hakkaart-van Roijen, L.

PY - 2017

Y1 - 2017

N2 - Background: Current guidelines recommend referral to highly specialized care for patients with severe personality disorders. However, criteria for allocation to highly specialized care are not clearly defined. The aim of the presentstudy was to develop a decision tool that can support clinicians to identify patients with a personality disorder in need of highly specialized care.Methods: Steps taken to develop a decision tool were a literature search, concept mapping, a meeting with experts and a validation study.Results: The concept mapping method resulted in six criteria for the decision tool. The model used in concept mapping provided a good fit (stress value = 0.30) and reasonable reliability (ρ = 0.49). The bridging values were low, indicating homogeneity. The decision tool was subsequently validated by enrolling 368 patients from seven centers. A multilevel model with a Receiver Operating Characteristic Curve (ROC) was applied. In this way, an easily implementable decision tool with relatively high sensitivity (0.74) and specificity (0.69) was developed.Conclusions: A decision tool to identify patients with personality disorders for highly specialized care was developed using advanced methods to combine the input of experts with currently available scientific knowledge. The tool appeared to be able to accurately identify this group of patients. Clinicians can use this decision tool to identify patients who are in need of highly specialized treatment.

AB - Background: Current guidelines recommend referral to highly specialized care for patients with severe personality disorders. However, criteria for allocation to highly specialized care are not clearly defined. The aim of the presentstudy was to develop a decision tool that can support clinicians to identify patients with a personality disorder in need of highly specialized care.Methods: Steps taken to develop a decision tool were a literature search, concept mapping, a meeting with experts and a validation study.Results: The concept mapping method resulted in six criteria for the decision tool. The model used in concept mapping provided a good fit (stress value = 0.30) and reasonable reliability (ρ = 0.49). The bridging values were low, indicating homogeneity. The decision tool was subsequently validated by enrolling 368 patients from seven centers. A multilevel model with a Receiver Operating Characteristic Curve (ROC) was applied. In this way, an easily implementable decision tool with relatively high sensitivity (0.74) and specificity (0.69) was developed.Conclusions: A decision tool to identify patients with personality disorders for highly specialized care was developed using advanced methods to combine the input of experts with currently available scientific knowledge. The tool appeared to be able to accurately identify this group of patients. Clinicians can use this decision tool to identify patients who are in need of highly specialized treatment.

U2 - 10.1186/s12888-017-1460-6

DO - 10.1186/s12888-017-1460-6

M3 - Article

VL - 17

JO - BMC Psychiatry

JF - BMC Psychiatry

SN - 1471-244X

M1 - 317

ER -