Measuring Outcomes Brian Eastwood TOP Implementation Manager 2 June 2009

Measuring Outcomes (in the drug field) Clinical tool Performance assessment Value for money Capacity to predict, measure and report Are US studies applicable to UK population? TOP will help answer questions Shift from proxy to real outcomes Key performance indicators Numbers in effective treatment Waiting times 12 week retention

What we are planning to do with the data (1)

Level 0 Baseline Report

Level 1 Exit report

BaselineFollow up 0 28 A note on the reliable change index Formula for RCI = x 2 - x 1 S diff We first have to calculate the standard error of the difference term: S diff = √ 2 (SE) 2 Where: SE = S 1 √ 1 – r xx RCI is conservative. There is a substantial boundary that must be crossed in order to be deemed different – be it improved or deteriorated What predicts membership in these categories?

A note on the reliable change index – is it reflected in other domains?

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. XY A note on the case mix adjustment

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?