Reliable Risk Assessment Tool Research Articles

Reliability of risk assessment measures used in sexually violent predator proceedings.

The field interrater reliability of three assessment tools frequently used by mental health professionals when evaluating sex offenders' risk for reoffending--the Psychopathy Checklist-Revised (PCL-R), the Minnesota Sex Offender Screening Tool-Revised (MnSOST-R) and the Static-99-was examined within the context of sexually violent predator program proceedings. Rater agreement was highest for the Static--99 (intraclass correlation coefficient [ICC₁] = .78) and lowest for the PCL-R (ICC₁ = .60; MnSOST-R ICC₁ = .74), although all instruments demonstrated lower field reliability than that reported in their test manuals. Findings raise concerns about the reliability of risk assessment tools that are used to inform judgments of risk in high-stake sexually violent predator proceedings. Implications for future research and suggestions for improving evaluator training to increase accuracy when informing legal decision making are discussed.

Risky Business: Predicting Recidivism

Society has become more and more preoccupied with both the ascertainment and avoidance of risk. This preoccupation has permeated the criminal justice system and courts are increasingly being required to evaluate the risk of reoffending, when considering the imposition of sentences and other control measures, particularly in regard to crimes of violence and sexual offending. This has resulted in the need for reliable risk assessment tools and expert evidence to assist judges in their task. While health professionals have willingly provided such assistance, it is apparent that even the current generation of risk assessment tools are not without their limitations. This has led to some commentators suggesting that such tools merely provide a veil of science over what really are moral and ethical questions as to which offenders pose an unacceptable danger to society. While not subscribing to that view, this article emphasises the need for experts to convey the limitations of such instruments clearly to the courts. It also suggests that any tools used must be aligned with the statutory criteria and that such tools must be used in combination with an individualised assessment of risk for each offender. The reasoning process must be transparent and set out clearly for the court. As sentences based on risk have the potential to place major restrictions on the rights of offenders, courts must have as much assistance as possible in the task of balancing the human rights of offenders with the risk to public safety posed by such offenders. R v Peta [2007] 2 NZLR 627 (CA) is used as a case study to illustrate both what can go wrong, as well as an example of best practice in this often precarious balancing exercise.

From College Counselor to “Risk Manager”: The Evolving Nature of College Counseling on Today's Campuses

College counselors are increasingly being called upon to assess “risk” and protect the college community from harm. This paper explores how this changing role for counselors might be impacting its reputation with students. It further discusses the complex and ever-changing dimensions of “risk,” noting the difficulty in developing reliable risk assessment tools.

Pressure ulcer prevention and treatment practices in inpatient rehabilitation facilities.

Although many strategies have been developed to prevent pressure ulcers, they remain a significant healthcare problem, particularly for chronically ill patients in rehabilitation facilities. This study describes self-reported pressure ulcer prevention and treatment practices in rehabilitation facilities. Surveys were sent to all 52 licensed inpatient rehabilitation facilities in Missouri; the response rate was 76.9%. Less than 30% of the facilities used inexpensive nursing interventions such as keeping the head of a patient's bed at or below a level of 30 degrees. Informally established protocols were used more frequently than the evidence-based pressure ulcer prevention and treatment guidelines issued by the Agency for Health Care Policy and Research. Furthermore, only 50% of the respondent facilities used established, valid, and reliable risk assessment tools. There was little difference in the interventions used when a client either developed a pressure ulcer or was assessed as being at risk for an ulcer. These findings reveal a significant gap between research and practice and suggest a need to educate rehabilitation nurses about the most appropriate, evidence-based nursing interventions for preventing and treating pressure ulcers.

Interrater reliability and the assessment of pressure-sore risk using an adapted Waterlow Scale

Objective: the purpose of this paper is to highlight the issue and the complexity of the assessment of interrater reliability in the assessment of pressure sore risk. Design: an empirical study undertaken to assess the interrater reliability of an adapted Waterlow Scale is described. The scores obtained from 15 patients on two wards are presented. Each patient was assessed daily by two different nurses over a period of 7 days. A total of 210 assessments were obtained. Interrater reliability was assessed using two statistical techniques: percentage of agreement and correlation. Setting: the elderly care unit of a district general hospital in the North of England. Participants: twenty-eight ward staff and the research corrdinator. Results: the statistical tests showed a weak/moderate degree of interrater reliability.A comparison of the reliability coefficients obtained from these tests with a visual examination of the actual scores obtained by the raters is made and discussed in relation to the clinical acceptability of reliability coefficients. Conclusions 1. The relationship between statistical acceptability and clinical acceptability needs to be further explored particularly in relation to the assessment of pressure sore risk. 2. Further investigation into the reliability of risk assessment tools is needed toidentify if and under what circumstances they are effective and what training in the use of the tool is needed to improve and maintain reliability and theraby be of any real practical use.