Strategies for comparing routinely collected outcome data across services or systems include focusing on a common indicator (e.g., symptom change) or aggregating results from different measures or outcomes into a comparable core metric. The implications of either approach for judging treatment success are not fully understood. This study drew on naturalistic outcome data from 1641 adolescents with moderate or severe anxiety and/or depression symptoms who received routine specialist care across 60 mental health services in England. The study compared rates of meaningful improvement between the domains of internalizing symptoms, functioning, and progress towards self-defined goals. Consistent cross-domain improvement was observed in only 15.6% of cases. Close to one in four (24.0%) young people with reliably improved symptoms reported no reliable improvement in functioning. Inversely, one in three (34.8%) young people reported meaningful goal progress but no reliable symptom improvement. Monitoring systems that focus exclusively on symptom change risk over- or under-estimating actual impact, while aggregating different outcomes into a single metric can mask informative differences in the number and type of outcomes showing improvement. A move towards harmonized outcome measurement approaches across multiple domains is needed to ensure fair and meaningful comparisons.

比较跨服务或系统定期收集的结果数据的策略包括关注共同指标（例如症状变化）或将不同措施或结果的结果汇总为可比较的核心指标。这两种方法对判断治疗成功的影响尚不完全清楚。这项研究利用了 1641 名患有中度或重度焦虑和/或抑郁症状的青少年的自然结果数据，这些青少年在英格兰 60 个心理健康服务机构接受了常规专业护理。该研究比较了内化症状、功能和实现自我定义目标的进展等领域之间的有意义的改善率。仅在 15.6% 的案例中观察到一致的跨域改进。近四分之一 (24.0%) 症状确实得到改善的年轻人表示，功能没有得到可靠的改善。相反，三分之一（34.8%）的年轻人报告说取得了有意义的目标进展，但没有可靠的症状改善。专门关注症状变化的监测系统可能会高估或低估实际影响，而将不同的结果汇总到单个指标中可能会掩盖显示改善的结果数量和类型的信息差异。需要跨多个领域采取统一的结果衡量方法，以确保公平和有意义的比较。