There is emerging evidence that the performance of risk assessment instruments is weaker when used for clinical decision‐making than for research purposes. For instance, research has found lower agreement between evaluators when the risk assessments are conducted during routine practice. We examined the field interrater reliability of the Short‐Term Assessment of Risk and Treatability: Adolescent Version (START:AV). Clinicians in a Dutch secure youth care facility completed START:AV assessments as part of the treatment routine. Consistent with previous literature, interrater reliability of the items and total scores was lower than previously reported in non‐field studies. Nevertheless, moderate to good interrater reliability was found for final risk judgments on most adverse outcomes. Field studies provide insights into the actual performance of structured risk assessment in real‐world settings, exposing factors that affect reliability. This information is relevant for those who wish to implement structured risk assessment with a level of reliability that is defensible considering the high stakes.

中文翻译：

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将“老板”带入现实世界：风险和可治疗性短期评估的现场跨度可靠性：青少年版

越来越多的证据表明，用于临床决策的风险评估工具的性能比用于研究目的的性能要弱。例如，研究发现，在常规实践中进行风险评估时，评估人员之间的共识较低。我们检查了短期风险和可治疗性评估：青少年版本（START：AV）的现场界面可靠性。在荷兰安全的青年护理机构中的临床医生已完成START：AV评估，作为治疗常规的一部分。与以前的文献一致，项目间的可靠性和总分低于非田间研究的先前报告。尽管如此，对于大多数不良结局的最终风险判断，仍发现中等至良好的间质可靠性。现场研究提供了对现实环境中结构化风险评估的实际绩效的洞察力，揭示了影响可靠性的因素。此信息与那些希望实施结构化风险评估且其可靠性水平在高风险的情况下可以辩护的人员相关。