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PubMed2001

A general population comparison of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN).

BACKGROUND: In psychiatric surveys of the general population, there has been considerable discrepancy between diagnoses obtained by fully structured interviews and those established by systematic semi-structured clinical evaluation. The Composite International Diagnostic Interview (CIDI) is an example of the first type of interview widely used in general population surveys. We compared its performance in diagnosing current depressive and anxiety disorders with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), a semi-structured diagnostic interview administered by clinically trained interviewers. METHODS: Household addresses in Leicestershire, UK, were randomly sampled and 860 adults were screened with the Revised Clinical Interview Schedule. Adults with too few symptoms to fulfil diagnostic criteria for study disorders were excluded to increase the proportion re-interviewed who met such criteria. Repeat diagnostic interviews with the CIDI and SCAN, ordered randomly, were sought from eligible screen positive respondents. Recalibrated CIDI prevalence estimates were derived from the SCAN classification using Bayesian statistics. RESULTS: Concordance ranged between 'poor' and 'fair' across almost all types of study disorders, and for co-morbidity. Concordance was somewhat better for severity of depression and when lower diagnostic thresholds were used for depression. Interview order effects were suggested with lower concordance when CIDI followed SCAN. Recalibration reduced the prevalence of depressive or anxiety disorder from 9.0 to 6.2%. CONCLUSIONS: Community psychiatric surveys using structured diagnostic interview data must be interpreted cautiously. They should include an element of clinical re-appraisal so findings can be adjusted for estimation differences between fully structured and clinical assessments.

Adolescent↗
PubMed1999

The survey form of SCAN: the feasibility of using experienced lay survey interviewers to administer a semi-structured systematic clinical assessment of psychotic and non-psychotic disorders.

BACKGROUND: The success of large scale surveys depends on well designed questionnaires and the skills of lay interviewers. Discrepancies in prevalence rates between epidemiological surveys and poor agreement between survey interviewer and clinician diagnostic interviews are giving rise to increasing concern among researchers, public health planners and policy developers. New approaches to information collection are called for. The feasibility of training experienced survey interviewers in semi-structured, clinical, diagnostic interviewing has never been investigated systematically across the range of neurotic and psychotic disorders. METHODS: Eight experienced survey interviewers from the Office for National Statistics (ONS) were selected and underwent extended training in a Survey Form of SCAN (SCAN-SF). Sixty-four adults, including a majority of psychiatric in-patients were assessed by ONS interviewers and reinterviewed within a week by SCAN-trained clinicians. Feedback was sought from interviewers and trainers. RESULTS: Trainers found lay interviewers coped at least as well with psychotic as with neurotic symptoms. Concordance for any disorder was 0.74 (95% CI: 0.57 to 0.91); for any specific psychotic disorder 0.63 (0.40 to 0.86); for any specific neurotic disorder 0.63 (0.43 to 0.83). Sensitivity ranged from 0.6 to 0.9 and specificity from 0.8 to 0.9. There was no evidence of rater bias. CONCLUSIONS: These preliminary findings are very promising. However, before the SCAN-SF, administered by carefully trained lay interviewers, can be recommended in large scale surveys, further evaluations of its feasibility and reliability in the general population are needed.

Adaptation, Psychological↗
PubMed1998

Reliability of data on smoking habit and coffee drinking collected by personal interview in a hospital-based case-control study.

A study on the reliability of information on smoking habits and coffee drinking collected via interview was conducted among 500 subjects enrolled in a case-control study on bladder cancer in Brescia, North Italy. A total of 215 cases (incident and prevalent) and 285 controls were interviewed personally in the hospital setting by a first interviewer, and then re-interviewed by telephone by either the same interviewer or another one. Agreement between the first and second interview was evaluated using the kappa statistic and the intra-class correlation coefficient and via multiple logistic regression modelling. No important differences in reliability were found according to sex, education or case/control status, while agreement was better among subjects below 65 than among older ones, and among incident than prevalent cases. A slightly better agreement was found among subjects interviewed twice by the same interviewer than those interviewed by two different individuals, which may reflect the presence of inter-observer reliability for the latter. Overall, these results show a very high reliability of data on smoking and a fairly high reliability regarding coffee drinking as collected through face-to-face interviews.

Adult↗
PubMed2003

Comparisons of three different investigative interview techniques with young children.

After viewing a film of a mother hitting her son, a film not seen by the college student interviewers, children were misinformed about a detail (via exposure to a misleading question) as well as explicitly coached to disclose 3 false details. The children were then interviewed by interviewers who had previously learned 1 of 3 different interviewing procedures: the Yuille Step-Wise Interview developed by J. C. Yuille, R. Hunter, R. Joffe, & J. Zapamiuk (1993); a doll play interview developed by Action for Child Protection Inc. (1994); or the Modified Structured Interview developed for this study. The Modified Structured Interview yielded more "where" information and was better at detecting if coaching had occurred. However, the interviewers were not very good at discriminating suggested versus coached versus correct witnessed information. The authors found that the deeper one digs for memories, the more one uncovers incorrect versus correct items. They concluded that although the Modified Structured Interview was superior to the techniques currently in use, cautions are necessary.

Aggression↗
PubMed2004

Reflecting on the experience of interviewing online: perspectives from the Internet and HIV study in London.

This paper considers some of the strengths and weaknesses of conducting synchronous online interviews for qualitative research. It is based on a study among gay/bisexual men that used both qualitative and quantitative methods to explore the association between seeking sex through the Internet and HIV transmission risk. Between June 2002 and January 2004, 128 gay/bisexual men living in London were interviewed one-to-one by the first author (MD) about their experience of using the Internet to find sexual partners and negotiating condom use for anal sex. Thirty-five men were interviewed online, while 93 were interviewed face-to-face (i.e. offline). This paper draws on MD's experience of conducting these interviews--both online and face-to-face. Synchronous online interviews have the advantage of being cheap, convenient and attractive to people who do not like face-to-face interviews. However, some of the social conventions and technical limitations of computer-mediated-communication can introduce ambiguity into the online dialogue. To minimize this ambiguity, both interviewer and interviewee have to edit their online interaction. One of the distinctive features of the online interview is that it emerges as a form of textual performance. This raises fundamental questions about the suitability of the synchronous online interview for exploring sensitive topics such as risky sexual behaviour.

Adult↗
PubMed2006

Parents' reactions to participating in interviews about end-of-life decision making.

BACKGROUND: Although in-depth interviewing is well suited to studying the sensitive topic of end-of-life decision making, no reports have been published assessing the effects on parents of participating in interviews regarding end-of-life decision making for critically ill children. OBJECTIVE: To examine the reactions of pediatric intensive care unit (PICU) patients' parents to interviews on end-of-life decision making for their child. METHODS: We conducted semistructured interviews on end-of-life decision making with PICU patients' parents from two tertiary care PICUs. We approached 117 parents of 102 patients. Seventy-four parents (63%) of 69 patients participated. RESULTS: Forty-three parents (61%) described the interview as "a good experience," 20 (29%) as "a neutral experience," and 1 (1%) as "a bad experience." The parent who judged the interview negatively stated that, "It bothers me a little bit because my son is [out] there having difficulties and I'm in here and not out there." Fifty-four of 59 parents (92%) said they would participate in another similar interview. Most parents (92%) felt the medical community should continue research on end-of-life decision making. Themes identified from the responses included: emotional reaction to the interviews; exposure to end-of-life decision-making issues; impact on parents' views; and impact on future end-of-life decision making. Parents' comments suggested that many perceived the interviews as beneficial. CONCLUSIONS: This study demonstrates the willingness of many parents of critically ill children to participate in study interviews regarding end-of-life decision making, a topic that most parents felt was important and warranted more research.

Adult↗
PubMed1985

A comparison of computer-assisted and hard copy telephone interviewing.

In computer-assisted telephone interviewing, questions are displayed on a computer screen, and responses are entered directly into a computerized data file. In 1981-1982, a randomized trial of computer-assisted telephone interviewing, compared with telephone interviewing with responses directly recorded on printed questionnaires, was carried out. The respondents were surrogates for 400 white Florida residents who died in 1979 and were randomly selected from a death certificate-based case-control study of colorectal cancer. Outcomes examined included participation rate after initial phone contact, length of interview, recorded number of comments, recorded number of probes, unresolved "don't know" responses, and the interviewer's evaluation of the quality of the interview. The computer-assisted telephone interviewing system resulted in the 25-30-minute interviews lasting, on the average, 3.4 minutes (14%) longer. The average number of comments decreased from 5.5 to 4.1 (a 25% difference) and probes from 10.2 to 8.3 (a 19% difference) in the computer-assisted interviews. These differences were markedly smaller than the differences noted between individual interviewers.

Analysis of Variance↗
PubMed1994

Objective system for interviewer performance evaluation for use in epidemiologic studies.

In this paper, the authors present an objective system to evaluate interviewer performance for use in epidemiologic studies. With this quality control system, all study interviews are audio-taped, and a random sample of interviews are coded according to interviewer behaviors, such as whether the interviewer asked the questions exactly as written and used the probes appropriately. With the use of data obtained from a large case-control study of colon cancer, the authors observed that 94.2% of all questions were asked in the same manner by all interviewers and that 89.5% of all probing behaviors were appropriate. They show that questions that required additional interviewer behaviors were more likely to result in variation in response that can be attributed to the interviewer. These findings have implications for study design and interpretation of study results. From simulations, the authors have estimated the impact of uncorrected interviewer variability on study power and ability to detect disease associations. Uncorrected interviewer variability could decrease study power from 84% to 56%. From simulations, the authors observed that odds ratios could be biased downward from 1.8 to 1.3. These findings illustrate the importance of using a continuous quality control program in epidemiologic research.

Epidemiologic Methods↗
PubMed1976

A standardized interviewing technique for evaluating postgraduate training applicants.

In an effort to streamline the personal interview and to reduce the influence of subjectivity inpreparation of ranking lists for postgraduate year-one applicants, a standardized interview was constructed for use in evaluating condidates for admission to a training program in internal medicine. The interview was conducted in a uniformly structured manner by 14 interviewers of 260 applicants. Each applicant received an interview score which correlated well with the final decision of the Intern Selection Committee. For each interviewer various measures of performance were obtained which allowed a classification into "hard" versus "easy" interviewer and indicated the comparability of each interview's evaluations with the final decisions. Thus, the standardized interview resulted in quantifiable data in the form of uniform evaluations of applicants and interviewers.

Educational Measurement↗
PubMed1992

Relationship of medical students' admission interview scores to their dean's letter ratings.

The authors examined the relationship between the admission interview scores for 62 students in the 1986 entering class at Dartmouth Medical School and the students' dean's letter ratings given four years later; they found the relationship to be significant (V = .372, p = .014) and the interview scores to be better independent predictors of the ratings than were total Medical College Admission Test scores or science grade-point averages. Among the 17 students receiving "strong" admission interview scores, 53% received dean's letter ratings in the top one-third and 47% received ratings in the lower two-thirds. Of those 34 who received "medium" interview scores, 68% received ratings in the lower two-thirds; all 11 students who received "weak" interview scores received ratings in the lower two-thirds. The authors suggest (1) that admission interview scores help schools to identify more clearly those applicants most likely to become strong, competitive performers in residency and (2) that the significant relationship between interview scores and dean's letter ratings indicates a need to discover what qualities the interview actually measures and to consider the methods by which interviewers are trained, rather than to forsake the interview.

Interviews as Topic↗
PubMed1994

Interviewing prepubertal children about suicidal ideation and behavior.

OBJECTIVE: Much of the literature on assessment of suicidal children has focused on identifying risk factors associated with suicidal ideation and behavior in this population. Unique problems encountered in interviewing prepubertal children about suicidal ideation and behavior are examined in this paper. METHOD: Observations of problems encountered in interviewing prepubertal children about suicidal ideation and behavior were gleaned in the context of interviews of children admitted to a child psychiatry inpatient unit and interviews of the parents of these children. RESULTS: Unique problems include difficulties in assessment of suicidal intent, impact of cognitive development, particularly of the concept of death, interaction between current emotional state and memory of previous suicidal episodes, characteristics of play associated with suicidal states, effects of parents' attitudes toward assessment on information gathering, and the impact of certain risk factors on cognition and behavior during the interview. CONCLUSION: Interviewing children about suicidal ideation and behavior necessitates that the clinician attend to multiple elements of the interview simultaneously. These interviews are further complicated by the stressful thoughts and feelings that can be raised in both clinician and child in reaction to exploring the child's suicidal ideation and behavior. Additional research is needed to refine the process of reliable interviewing of children about suicidal ideation and behavior and to develop instruments both to quantitate the different elements of these interviews and to guide the clinicians conducting them.

Adolescent↗
PubMed2004

Comparability of telephone and face-to-face interviews in assessing patients with posttraumatic stress disorder.

INTRODUCTION: Structured clinical interviews are very important in the area of mental health research and services. Prior research comparing the reliability and validity of face-to-face and phone interviews has found high levels of agreement. This project compared the results of face-to-face and phone interviews for two widely used measures: The Clinician-Administered PTSD Scale (CAPS) for assessing posttraumatic stress disorder diagnostic status and symptom severity and the Hamilton Rating Scale for Depression (Ham-D) to determine the severity of major depressive disorder. METHOD: Subjects were 34 veterans recruited from applicants to the PTSD Assessment and Intervention program at the Cincinnati VA Medical Center. Order of interview (in-person or phone) was determined using random assignment within a counterbalanced framework. After attaining satisfactory levels of interrater reliability, four clinicians independently and blindly evaluated the subjects. RESULTS: Pearson correlation coefficients between face-to-face and phone interviews revealed high consistency (CAPS r = 0.745, HAM-D r = 0.748). The level of agreement between the two methods was 82% for the CAPS and 85% for the HAM-D. Diagnostic thresholds for the CAPS and HAM-D, after adjusting for the interview order and time elapsed between interviews, did not differ between the two groups (p = 0.31 for the CAPS and p = 0.96 for the HAM-D). High levels of agreement were achieved between the two methods (kappa = 0.75 for the CAPS using a cutoff of 65 and 0.70 for the HAM-D). The high sensitivity, specificity, and predictive values support the reliability of the phone-interview method. CONCLUSION: Phone interviews are a reliable method of interviewing for use in assessing patients for posttraumatic stress disorder and major depressive disorder.

Aged↗
PubMed1993

Subjective and behavioural evaluation of the teaching of patient interview skills.

One aim of the course in general practice and public health medicine during the final year at the University of Sheffield is to help students to develop further their interpersonal communication skills with particular reference to their skills in interviewing patients. During the course students meet twice in small groups with a tutor in order to review audiotape recordings of interviews with patients seen during their general practice attachments. The main activity during these tutorials is group discussion of the interviewer's behavioural options at significant points during the interview. Students also listen individually with a tutor to an interview that they have recorded, discuss this interview and assess it against a set of explicit criteria as part of their summative course assessment. In response to an anonymous end-of-course questionnaire, 85% of students felt that their interview skills had been improved by the teaching and 68% that listening to their own recordings had been the most helpful aspect. During interviews with simulated patients recorded at the end of the course, students asked more open questions, fewer questions referring to physical symptoms, more questions referring to feelings, beliefs or behaviour and fewer questions of a check-list type than during interviews recorded at the start. A number of students also requested examples of specific events during the end-of-course interviews although none had done so at the beginning of the course. All of these changes were statistically significant and were in directions that were consistent with the teaching in the small-group tutorials.

Clinical Competence↗
PubMed2005

Audiovisual touch-screen computer-assisted self-interviewing for donor health histories: results from two years experience with the system.

BACKGROUND: The donor history interview is an important aspect of blood safety, in part designed to identify unsuitable donors who may present a risk to blood recipients. There is evidence from behavioral science literature that use of computer-assisted interviewing may be superior to face-to-face (FTF) and paper techniques in eliciting sensitive behavioral information of interest to blood collection facilities. STUDY DESIGN AND METHODS: Audiovisual touch-screen computer-assisted donor self-interviewing with the AABB Uniform Donor History Questionnaire was deployed for routine use in a regional blood center replacing FTF interviews. Donor and staff perception and satisfaction surveys were performed to assess acceptance of the system. Time studies of automated and manual methods were conducted. Rates of deferral of first-time donors for high-risk behaviors and rates of errors and omissions on donor interviewing for the two systems were tabulated and compared. RESULTS: Donors and staff strongly preferred the automated system in all dimensions assessed. Donor time increased by 4 minutes but staff time declined by 5 minutes per interview. Identification of high-risk behaviors among first-time donors significantly increased. Rates of errors and omissions on donor history forms identified at audit were reduced. CONCLUSIONS: Both blood donors and collections staff enthusiastically accepted the automated donor interviewing system. A well-designed audiovisual touch-screen donor self-interviewing system is superior to face-to-face interviewing and most likely more effective than paper interviewing.

Attitude of Health Personnel↗
PubMed2004

The psychoanalytic research interview: preliminary suggestions.

Psychoanalytically informed interview techniques and interview analysis can yield useful psychoanalytic insights about a particular research subject within the space of a few interviews. Basic hermeneutic principles, often used to understand the research interview, are not sufficient for understanding unconscious meaning and intrapsychic processes; they pay little attention to the particular theoretical and technical aspects of the interview needed to create the best conditions for understanding unconscious meaning. The portability of psychoanalytic concepts and their applicability outside the therapeutic setting are considered, after which four epistemological principles are outlined, derived mainly from the narrative tradition in psychoanalysis, that can inform interview technique and the analysis of the interview. Careful attention to feeling states, the search for core narratives, and the exploration of identifications and object relations are isolated as key analytic tasks in the interview analysis. A brief verbatim interview is used to illustrate this process, and methods are suggested to prevent the "wild analysis" of the interview encounter.

Humans↗
PubMed2000

Reliability of interview-assessed hostility ratings across mode of assessment and time.

These studies addressed 2 questions concerning interview-based hostility assessments: whether they are affected if the interview is conducted face-to-face versus telephone and whether they are stable across an extended time period. In Study 1A, 54 students were interviewed face-to-face and by telephone in a laboratory setting. Half the sample was reinterviewed in the laboratory 6 weeks later. The other half was reinterviewed by telephone at home. With 1 exception, all intraclass correlation coefficients (ICCs) comparing interview modes were above .62. In Study 1B, 48 adults were interviewed face-to-face in a laboratory and by telephone in their homes with a 2-week intervening interval. The ICC comparing interview modes was .78. In Study 2, 100 adults were interviewed face-to-face in a laboratory and approximately 4 years later by telephone in their homes. The ICC across interviews was .69. Thus, support was found for the stability of interview-based hostility assessments across interview methods and extended periods of time.

Adult↗
PubMed2000

[Patient-centered interviews in general practice].

Many studies have confirmed that the interview approach adopted by the physician influences the quality of the doctor-patient relationship as well as the accuracy and validity of information which is elicited during the medical interview. A correct interview approach is also the basis for diagnosis and treatment. This paper summarizes the main characteristics of the patient-centred interview approach which has to integrate the doctor centred approach in order to render the medical interview efficient in terms of data collection, doctor-patient relationship and time. The first part of the interview with the patient has always to be patient-centred. The patient is facilitated to report all the information regarding his symptoms and their psychosocial context and to express his ideas and expectations, after which the interview style becomes more directive and doctor-led. In this phase the doctor remaining however attentive to patient's cues. Some data are presented which describe the prevailing interview approach of general practitioners without any formal training in patient-centred interview techniques. The analysis of doctors' verbal behaviour during the consultation confirmed the necessity of educational interventions focalized on the improvement of doctors' interview skills.

Clinical Competence↗
PubMed2004

Computer interviewing in a primary care office: the patients are ready.

UNLABELLED: Computer patient interviewing has been used since 1968 and must be acceptable to a majority of patients for wide spread use to occur. Computer interviewing is still not used widely in the United States. Potential barriers have not been identified in the literature. METHODS: 150 of 164 (91.5%) eligible patients at a family medicine ambulatory practice were enrolled in a study to evaluate computer interview of cough and sore throat complaints. Subjects were given the choice to have the interview in the waiting or examination room. Telephone interviews were conducted 2-4 weeks later with 143/150 patients (95.3%). RESULTS: 102/150 (68%) of subjects chose the wait-ing room and 48/150 (32%) chose the examination room for the computer interview. 127/143 (88.8%) were willing to use the computer interview for evaluation of cough or sore throat again in the future. 116/143 (81.1%) were willing to use the computer interview for other medical complaints in the future. CONCLUSIONS: Patients are willing to use computer interview-ing and some interviews may be conducted in the waiting room.

Adolescent↗