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## Complete Summary

#### TITLE

Mental health/substance abuse: mean of patients\' change scores on the
\"Self-harm\" subscale of the BASIS-24® survey.

#### SOURCE(S)

BASIS-24® (Behavior And Symptom Identification Scale). Belmont (MA):
McLean Hospital, Department of Mental Health Services Evaluation; 2001.
4 p.

Behavior And Symptom Identification Scale: BASIS-24® instruction guide.
Belmont (MA): McLean Hospital, Department of Mental Health Services
Evaluation; 32 p.

### Measure Domain

#### PRIMARY MEASURE DOMAIN

Outcome

The validity of measures depends on how they are built. By examining the
key building blocks of a measure, you can assess its validity for your
purpose. For more information, visit the [Measure
Validity](http://www.qualitymeasures.ahrq.gov/resources/measure_domains.aspx)
page.

#### SECONDARY MEASURE DOMAIN

Does not apply to this measure

### Brief Abstract

#### DESCRIPTION

This measure is used to assess patients\' change scores on the BASIS-24®
survey \"Self-harm\" subscale\*. The BASIS-24® survey is administered at
the beginning of a treatment episode, with repeat assessments obtained
at desired intervals to assess change during or following treatment.

\*\"Self-harm\" is one of six subscales of the
[BASIS-24®](http://www.qualitymeasures.ahrq.gov/browse/DisplayOrganization.aspx?org_id=1892&doc=9875#data).

#### RATIONALE

The Behavior and Symptom Identification Scale (BASIS-24®) is a
consumer-oriented self-report survey. The rationale for the survey
measures include: 1) need to measure mental health outcomes associated
with specific episodes of care; 2) need to assess outcomes from the
consumer perspective; 3) need to measure mental health status according
to symptoms and functional problems consumers identify as important and
using items empirically derived directly from patients/clients.

The 24-item BASIS-24® was developed to meet the need for a brief, but
comprehensive mental health status measure useful in assessing the
outcome of mental health treatment from the consumer\'s point of view.
The BASIS-24® is a measure of self-reported difficulty in the major
symptom and functioning domains that lead to the need for mental health
services. The 24 items assess six major areas of difficulty and/or
distress: depression/functioning, relationships, self-harm, emotional
lability, psychosis, and substance abuse. BASIS-24® is not
diagnosis-specific, but was designed to cut across diagnoses,
acknowledging the wide range of symptoms and problems that occur across
the diagnostic spectrum.

#### PRIMARY CLINICAL COMPONENT

Mental health; substance abuse; self-harm; Behavior And Symptom
Identification Scale (BASIS-24®)

#### DENOMINATOR DESCRIPTION

Adult patients 18 years of age and older who completed a BASIS-24®
survey at the beginning of psychiatric and/or substance abuse treatment
and at another point in the treatment process\* (see the related
\"Denominator Inclusions/Exclusions\" field in the Complete Summary)

\***Note**: Completion of the second survey may be at
discharge/termination or at another follow-up point during the episode
of care.

#### NUMERATOR DESCRIPTION

The mean of patients\' change scores on the \"Self-harm\" subscale\* of
the BASIS-24® survey

\***Note**: A change score is not calculated for patients if two or more
items from the \"Self-harm\" subscale are left blank (not answered).

### Evidence Supporting the Measure

#### EVIDENCE SUPPORTING THE CRITERION OF QUALITY

-   A formal consensus procedure involving experts in relevant clinical,
    methodological, and organizational sciences

-   Focus groups

-   One or more research studies published in a National Library of
    Medicine (NLM) indexed, peer-reviewed journal

### Evidence Supporting Need for the Measure

#### NEED FOR THE MEASURE

Unspecified

### State of Use of the Measure

#### STATE OF USE

Current routine use

#### CURRENT USE

Accreditation\
Internal quality improvement

### Application of Measure in its Current Use

#### CARE SETTING

Ambulatory Care\
Behavioral Health Care\
Hospitals\
Physician Group Practices/Clinics\
Rehabilitation Centers\
Residential Care Facilities\
Substance Use Treatment Programs/Centers

#### PROFESSIONALS RESPONSIBLE FOR HEALTH CARE

Advanced Practice Nurses\
Allied Health Personnel\
Nurses\
Physicians\
Psychologists/Non-physician Behavioral Health Clinicians\
Social Workers

#### LOWEST LEVEL OF HEALTH CARE DELIVERY ADDRESSED

Individual Clinicians

#### TARGET POPULATION AGE

Age greater than or equal to 18 years

#### TARGET POPULATION GENDER

Either male or female

#### STRATIFICATION BY VULNERABLE POPULATIONS

Unspecified

### Characteristics of the Primary Clinical Component

#### INCIDENCE/PREVALENCE

Unspecified

#### ASSOCIATION WITH VULNERABLE POPULATIONS

Unspecified

#### BURDEN OF ILLNESS

Unspecified

#### UTILIZATION

Unspecified

#### COSTS

Unspecified

### Institute of Medicine National Healthcare Quality Report Categories

#### IOM CARE NEED

Getting Better\
Living with Illness

#### IOM DOMAIN

Effectiveness\
Patient-centeredness

### Data Collection for the Measure

#### CASE FINDING

Users of care only

#### DESCRIPTION OF CASE FINDING

Adult patients 18 years of age and older who completed a BASIS-24®
survey at the beginning of psychiatric and/or substance abuse treatment
and at another point in the treatment process\*

\***Note**: Completion of the second survey may be at
discharge/termination or at another follow-up point during the episode
of care.

#### DENOMINATOR SAMPLING FRAME

Patients associated with provider

#### DENOMINATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Adult patients 18 years of age and older who completed a BASIS-24®
survey at the beginning of psychiatric and/or substance abuse treatment
and at another point in the treatment process\* (see the related
\"Denominator Inclusions/Exclusions\" field in the Complete Summary)

\***Note**: Completion of the second survey may be at
discharge/termination or at another follow-up point during the episode
of care.

**Exclusions**

-   Patients less than 18 years of age

-   Patients who cannot respond to a questionnaire or structured
    interview written at the 5th grade level

-   Patients with severe cognitive impairment such as dementia or mental
    retardation

#### RELATIONSHIP OF DENOMINATOR TO NUMERATOR

All cases in the denominator are equally eligible to appear in the
numerator

#### DENOMINATOR (INDEX) EVENT 

Clinical Condition\
Therapeutic Intervention

#### DENOMINATOR TIME WINDOW

Time window follows index event

#### NUMERATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
The mean of patients\' change scores on the \"Self-harm\" subscale of
the BASIS-24® survey

**Exclusions**\
A change score is not calculated for patients if two or more items from
the \"Self-harm\" subscale are left blank (not answered).

#### MEASURE RESULTS UNDER CONTROL OF HEALTH CARE PROFESSIONALS, ORGANIZATIONS AND/OR POLICYMAKERS

The measure results are somewhat or substantially under the control of
the health care professionals, organizations and/or policymakers to whom
the measure applies.

#### NUMERATOR TIME WINDOW

Episode of care

#### DATA SOURCE

Administrative data and patient survey

#### LEVEL OF DETERMINATION OF QUALITY

Not Individual Case

#### OUTCOME TYPE

Clinical Outcome

#### PRE-EXISTING INSTRUMENT USED

BASIS-24® (Behavior and Symptom Identification Scale)

### Computation of the Measure

#### SCORING

Weighted Score/Composite/Scale

#### INTERPRETATION OF SCORE

Better quality is associated with a higher score

#### ALLOWANCE FOR PATIENT FACTORS

Analysis by subgroup (stratification on patient factors, geographic
factors, etc.)\
Case-mix adjustment

#### DESCRIPTION OF ALLOWANCE FOR PATIENT FACTORS

Measure results may be stratified (e.g., diagnosis, age, gender, level
of care, etc\...).

#### STANDARD OF COMPARISON

External comparison at a point in time\
External comparison of time trends\
Internal time comparison

### Evaluation of Measure Properties

#### EXTENT OF MEASURE TESTING

Research for BASIS-24® was supported by grant RO1 MH58240 from the
National Institute of Mental Health and by the Veterans Administration
Health Services Research & Development program. A field test was
implemented at 27 treatment sites across the U.S 2,656 inpatients and
3,222 outpatients participated. Factor analytic methods, Classical Test
Theory (CTT) and Item Response Theory (IRT) modeling were used to select
the most discriminating, nonredundant items for inclusion in the final
version of the instrument and to assess its reliability and validity.
IRT modeling was used to score the instrument.

#### EVIDENCE FOR RELIABILITY/VALIDITY TESTING

Eisen SV, Normand SL, Belanger AJ, Spiro A 3rd, Esch D. The Revised
Behavior and Symptom Identification Scale (BASIS-R): reliability and
validity. Med Care2004 Dec;42(12):1230-41. \[50 references\]
[PubMed](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15550803)

### Identifying Information

#### ORIGINAL TITLE

Behavior And Symptom Identification Scale (BASIS-24®): self-harm.

#### MEASURE COLLECTION

[BASIS-24®](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=1892&doc=9875)

#### SUBMITTER

McLean Hospital, Department of Mental Health Services Evaluation

#### DEVELOPER

Eisen, Susan V. PhD

#### FUNDING SOURCE(S)

Unspecified

#### COMPOSITION OF THE GROUP THAT DEVELOPED THE MEASURE

Unspecified

#### FINANCIAL DISCLOSURES/OTHER POTENTIAL CONFLICTS OF INTEREST

Unspecified

#### ADAPTATION

The 24-item Behavior and Symptom Identification Scale (BASIS-24®) was
adapted from the 32-item Behavior and Symptom Identification Scale
(BASIS-32®).

#### PARENT MEASURE

Behavior and Symptom Identification Scale (BASIS-32®) (Susan V. Eisen,
PhD)

#### RELEASE DATE

2004 Oct

#### MEASURE STATUS

This is the current release of the measure.

#### SOURCE(S)

BASIS-24® (Behavior And Symptom Identification Scale). Belmont (MA):
McLean Hospital, Department of Mental Health Services Evaluation; 2001.
4 p.

Behavior And Symptom Identification Scale: BASIS-24® instruction guide.
Belmont (MA): McLean Hospital, Department of Mental Health Services
Evaluation; 32 p.

#### MEASURE AVAILABILITY

The individual measure, \"Behavior and Symptom Identification Scale
(BASIS-24®): Self-harm,\" is available in \"Behavior and Symptom
Identification Scale: BASIS-24® Instruction Guide.\" The Basis-24®
survey is available from the [McLean BASIS plus™ Web
site](http://www.basissurvey.org/pdf/BASIS24.pdf).

For more information contact, McLean Hospital, Department of Mental
Health Services Evaluation, 115 Mill Street, Belmont, MA 02478; Phone:
(617)855-2424; Fax: (617)855-2948; Web site:
[www.basissurvey.org](http://www.basissurvey.org/)

#### COMPANION DOCUMENTS

The following is available:

-   BASIS-24®: information sheet. Belmont (MA): McLean Hospital,
    Department of Mental Health Services Evaluation; 2 p. This document
    is available in Portable Document Format (PDF) from the [McLean
    BASIS plus™ Web
    site](http://www.basissurvey.org/pdf/Basis-24ProductSheet.pdf).

#### NQMC STATUS

This NQMC summary was completed by ECRI on November 29, 2006. The
information was verified by the measure developer on January 17, 2007.

#### COPYRIGHT STATEMENT

Copyright © McLean Hospital

Use of BASIS-24 requires a license from McLean Hospital. Refer to
[www.basissurvey.org](http://www.basissurvey.org/) for information on
licensing.

### Disclaimer

#### NQMC DISCLAIMER

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© 2008 National Quality Measures Clearinghouse

Date Modified: 11/3/2008