Psychometric Validation of the Brief Outcome Survey: A Transdiagnostic Tool for Measurement-Based Care

Abstract

ABSTRACT Background Measurement-based care (MBC) is a fundamental component of evidence-based psychotherapy that has the potential to improve the landscape of behavioral and mental health (BMH) care for youth and families. Objective The purpose of this study was to assess the reliability, validity, and clinical utility of the Brief Outcome Survey (BOS) when used as part of a comprehensive MBC approach during a course of evidence-based psychotherapy. Method The BOS is a three-item transdiagnostic tool designed to measure the impact of youth’s symptoms/conditions on functioning. Demographic and clinical data were obtained via a retrospective chart review of 75,000+ unique patient encounters over a period of 15 years. Internal consistency, test re-test reliability, construct validity, validity generalization, and clinical utility were assessed. Results Data were analyzed from 8,665 youth (Mage = 11.8 years; 57.2% biological female). The internal consistency coefficient (e.g. Cronbach’s alpha) ranged from 0.80–0.83 (first and second BOS administration). The single measure intraclass correlation coefficient was 0.66 (p < .001). Intraclass correlations between the BOS and the PHQ-9, GAD-7, and CY-BOCS were moderate. No significant differences were found by age. Cronbach’s alphas for the age groups ranged from 0.79–0.82. BOS scores were higher at baseline for biological females compared to males, t(8235) = 2.29, p < .001. Similarly, BOS scores were higher at baseline for youth receiving public versus private health insurance benefits, t(8032) = 2.29, p < .05. A one-way ANOVA revealed significant differences in BOS scores by diagnosis group and Cronbach’s alpha for the BOS was above 0.80 across all five diagnosis groups analyzed. Conclusions The BOS demonstrated evidence of strong psychometric properties and clinical utility, as a session-by-session transdiagnostic MBC tool.