This is a review of an open-access paper in BMC Psychiatry ‘A New Clinical Rating Scale for Work Absence and Productivity: Validation in Patients with Major Depressive Disorder’ by Lam, Michalek and Yatham and freely available here. In the journal, this paper is described as ‘Highly Accessed’ which is a neat feature of online journals – the ability to respond to the reader’s (passive) feedback. The title is self-explanatory. The researchers wanted to create a tool to measure productivity and work absence. Such tools apparently have not been ‘optimi(s)ed for clinical use’.
I sneaked ahead here and had a look at the clinical scale which is attached as a pdf. The question I had was ‘what would such a scale look like’. On looking at the scale it became immediately obvious that this was ‘optimised’ for depression. Essentially the questionnaire focuses on what the subject has been experiencing at work – more specifically how have depressive symptoms been influencing work. Examples include questions examining attention and irritability. It’s easy to see how these questionnaires can be adapted for different illnesses but slightly more difficult to see how they should be adapted to different work environments.
Returning to the questionnaire however, the researchers wanted to validate this so presumably it can be used in practice. The methodology starts to get quite technical although they are using standard procedures for validating questionnaires. They select subjects with major depressive disorder (DSM-IV) who are working and the selection criteria seemed quite reasonable. They administer other validated measures of productivity in the workplace and then correlate the scores across scales to determine if the LEAPS questionnaire is assessing the construct of interest. They investigate the internal reliability of the questionnaire items using a very specific statistical approach and then examine whether or not it is possible to discriminate different severities of depression. With the exception of a few minor deviations, the researchers demonstrate internal consistency, construct validity and discrimination of different severities of depression.
However I had just a few minor points. The work absence appears to be represented by a single item – how many hours of work were missed because of the way the person was feeling. This requests the subject to provide a numerical response although this is presumably continuous data. On the other hand, for issues around productivity subjects use likert responses which essentially are discrete. There are also more of these items being assessed. So in effect, the productivity element is being investigated to a greater extent than the work absence element. I wasn’t clear on how the questionnaire was going to be disseminated. In order to use the scale, the clinician will presumably need access to the normal distribution data to interpret the results. The questionnaire itself is completed by the subject.
More research is apparently underway with this questionnaire.
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