Reliability and validity of the FORUM-P and FORUM-C: two novel instruments for outcome measurement in forensic mental health

ABSTRACT

We conducted a series of tests on the FORensic oUtcome Measure (FORUM), a novel tool for measuring outcomes in forensic mental health services, which consists of complementary patient-reported (FORUM-P) and clinician-reported instruments (FORUM-C). Inpatients and outpatients at a UK forensic psychiatric regional service completed the FORUM-P and members of their clinical teams completed the FORUM-C. Patients and clinicians also provided qualitative feedback on the instruments. We assessed test-retest and inter-rater reliability in standard ways. Sixty-two patients participated with a mean age of 41.0 years (standard deviation 11.3). Thirty-five clinicians provided information about these patients. For internal consistency, Cronbach’s alpha for FORUM-P was 0.87 (95% confidence interval 0.80–0.93) and for FORUM-C was 0.93 (95% confidence interval 0.91–0.96). For test-retest reliability, weighted kappa for FORUM-P was 0.44 (95% confidence interval 0.24–0.63) and for FORUM-C was 0.78 (95% confidence interval 0.73–0.85). For inter-rater reliability, Spearman correlation coefficient for overall FORUM-C score between the first rating by clinician 1 and clinician 2 was 0.47 (95% confidence interval 0.18–0.69). For comprehensiveness, comprehensibility, and relevance FORUM-P and FORUM-C were both rated as good. FORUM-P and FORUM-C provide a novel, robust set of complementary instruments with promising psychometric properties for monitoring outcomes in forensic mental health.

KEYWORDS:

• Outcome measures
• quality of life
• psychometrics
• forensic psychiatry

Acknowledgements

The authors would like to thank Oxford Health NHS Foundation Trust and the members of the Forensic Outcome Measures Patient and Public Advisory Group for their support. Anybody wishing to use these measures should contact the copyright owners, the University of Oxford, via Dr. Howard Ryland, [email protected].

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

Howard Ryland, Doctoral Research Fellow, DRF-2017-10-019, was funded by the NationalInstitute for Health and Care Research (NIHR) for this research project. The views expressed in this publication are those of the authors and not necessarily those of the NIHR, NHS, or the UK Department of Health and Social Care.