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      A review of the psychometric properties of the Health of the Nation Outcome Scales (HoNOS) family of measures

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          Abstract

          Background

          The Health of the Nation Outcome Scales was developed to routinely measure outcomes for adults with mental illness. Comparable instruments were also developed for children and adolescents (the Health of the Nation Outcome Scales for Children and Adolescents) and older people (the Health of the Nation Outcome Scales 65+). All three are being widely used as outcome measures in the United Kingdom, Australia and New Zealand. There is, however, no comprehensive review of these instruments. This paper fills this gap by reviewing the psychometric properties of each.

          Method

          Articles and reports relating to the instruments were retrieved, and their findings synthesised to assess the instruments' validity (content, construct, concurrent, predictive), reliability (test-retest, inter-rater), sensitivity to change, and feasibility/utility.

          Results

          Mostly, the instruments perform adequately or better on most dimensions, although some of their psychometric properties warrant closer examination.

          Conclusion

          Collectively, the Health of the Nation Outcome Scales family of measures can assess outcomes for different groups on a range of mental health-related constructs, and can be regarded as appropriate for routinely monitoring outcomes.

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          Most cited references79

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          Construct validity in psychological tests.

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            Systematic reviews: synthesis of best evidence for clinical decisions.

            Systematic reviews can help practitioners keep abreast of the medical literature by summarizing large bodies of evidence and helping to explain differences among studies on the same question. A systematic review involves the application of scientific strategies, in ways that limit bias, to the assembly, critical appraisal, and synthesis of all relevant studies that address a specific clinical question. A meta-analysis is a type of systematic review that uses statistical methods to combine and summarize the results of several primary studies. Because the review process itself (like any other type of research) is subject to bias, a useful review requires clear reporting of information obtained using rigorous methods. Used increasingly to inform medical decision making, plan future research agendas, and establish clinical policy, systematic reviews may strengthen the link between best research evidence and optimal health care.
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              Health of the Nation Outcome Scales (HoNOS). Research and development.

              An instrument was required to quantify and thus potentially measure progress towards a Health of the Nation target, set by the Department of Health, "to improve significantly the health and social functioning of mentally ill people". A first draft was created in consultation with experts and on the basis of literature review. This version was improved during four stages of testing: two preliminary stages, a large field trial involving 2706 patients (rated by 492 clinicians) and tests of the final Health of the Nation Outcome Scales (HoNOS), which included an independent study (n = 197) of reliability and relationship to other instruments. The resulting 12-item instrument is simple to use, covers clinical problems and social functioning with reasonable adequacy, has been generally acceptable to clinicians who have used it, is sensitive to change or the lack of it, showed good reliability in independent trials and compared reasonably well with equivalent items in the Brief Psychiatric Rating Scales and Role Functioning Scales. The key test for HoNOS is that clinicians should want to use it for their own purposes. In general, it has passed that test. A further possibility, that HoNOS data collected routinely as part of a minimum data set, for example for the Care Programme Approach, could also be useful in anonymized and aggregated form for public health purposes, is therefore testable but has not yet been tested.
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                Author and article information

                Journal
                Health Qual Life Outcomes
                Health and Quality of Life Outcomes
                BioMed Central (London )
                1477-7525
                2005
                28 November 2005
                : 3
                : 76
                Affiliations
                [1 ]School of Population Health, The University of Melbourne, Melbourne, Australia
                [2 ]School of Population Health, The University of Queensland, Brisbane, Australia
                [3 ]New South Wales Institute of Psychiatry, Sydney, Australia
                Article
                1477-7525-3-76
                10.1186/1477-7525-3-76
                1315350
                16313678
                46ad49c1-c6c0-4153-8f60-6c3a63296a79
                Copyright © 2005 Pirkis et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 November 2005
                : 28 November 2005
                Categories
                Review

                Health & Social care
                health of the nation outcome scales for children and adolescents (honosca),health of the nation outcome scales (honos),health of the nation outcome scales 65+ (honos65+),outcome measurement,mental health

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