An Investigation of Interrater Reliability for the Rorschach Performance Assessment System (R-PAS) in a Nonpatient U.S. Sample.

The Rorschach Performance Assessment System (R-PAS) aims to provide an evidence-based approach to administration, coding, and interpretation of the Rorschach Inkblot Method (RIM). R-PAS analyzes individualized communications given by respondents to each card to code a wide pool of possible variables. Due to the large number of possible codes that can be assigned to these responses, it is important to consider the concordance rates among different assessors. This study investigated interrater reliability for R-PAS protocols. Data were analyzed from a nonpatient convenience sample of 50 participants who were recruited through networking, local marketing, and advertising efforts from January 2013 through October 2014. Blind recoding was used and discrepancies between the initial and blind coders' ratings were analyzed for each variable with SPSS yielding percent agreement and intraclass correlation values. Data for Location, Space, Contents, Synthesis, Vague, Pairs, Form Quality, Populars, Determinants, and Cognitive and Thematic codes are presented. Rates of agreement for 1,168 responses were higher for more simplistic coding (e.g., Location), whereas agreement was lower for more complex codes (e.g., Cognitive and Thematic codes). Overall, concordance rates achieved good to excellent agreement. Results suggest R-PAS is an effective method with high interrater reliability supporting its empirical basis.

Electroconvulsive therapy clinical database: a standardized approach in tertiary care psychiatry.

Across health care disciplines research reflects the usefulness of integrating computer technology into administrative and clinical practices. Electroconvulsive therapy (ECT) researchers are often interested in examining 3 primary areas: patient characteristics, treatment characteristics, and treatment outcomes. Generating reports and conducting research analysis via the traditional patient chart review are a time-consuming and costly method. At Riverview Hospital, a tertiary care psychiatric hospital, the active use of a clinical database for patients receiving ECT allows for detailed treatment tracking and evaluation of pretreatment and posttreatment patient outcome measures. Initially, designed as part of a quality improvement process to readily access patient information and generate periodic reports, the ECT clinical database is now a central resource for ECT-specific patient, treatment, and outcome tracking. The relevance, design, content variables, and subsequent functions of the entry and storage of ECT-related administrative, treatment, outcome, and patient factors are clearly outlined and discussed. Strengths and limitations to the existing database are shared. Recommendations to other ECT services to implement this valuable documentation strategy are addressed. This approach can be an invaluable tool in providing the field of psychiatry with further contributions to ECT clinical outcomes.