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Measuring Outcomes. Brian Eastwood TOP Implementation Manager 2 June 2009. Measuring Outcomes (in the drug field). Key performance indicators Numbers in effective treatment Waiting times 12 week retention.
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Measuring Outcomes Brian Eastwood TOP Implementation Manager 2 June 2009
Measuring Outcomes(in the drug field) • Key performance indicators • Numbers in effective treatment • Waiting times • 12 week retention Clinical toolPerformance assessmentValue for moneyCapacity to predict, measure and reportAre US studies applicable to UK population?TOP will help answer questionsShift from proxy to real outcomes
A note on the reliable change index Formula for RCI = x2 - x1 Sdiff 28 What predicts membership in these categories? We first have to calculate the standard error of the difference term: Sdiff = √ 2 (SE)2 Where: SE = S1 √ 1 – rxx 0 RCI is conservative. There is a substantial boundary that must be crossed in order to be deemed different – be it improved or deteriorated Baseline Follow up
A note on the reliable change index – is it reflected in other domains?
A note on the case mix adjustment X Y • Two agencies delivering the same treatment modality and agency Y is twice as effective as agency X • BUT • Agency X has twice the proportion of service users who are associated with poor outcome than agency Y. • With case-mix adjustment agency X is shown to be relatively more effective. • Case-mix adjustment captures the relative progress made given the starting point.
What we are planning to do with the data (2) • Research into • Opioid and crack treatment effects • RCI • Tier 4 • Cannabis • Employment, education and housing • Injecting • Health • Death • Integration into future key performance indicators
Measuring Outcomes- Alcohol? Is it appropriate for alcohol clients? Could it be a useful clinical tool? Working group to investigate TOP as a possibility? Develop a new outcomes measure?