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Published Online: 1 January 2013

DSM-5 Field Trials in the United States and Canada, Part I: Study Design, Sampling Strategy, Implementation, and Analytic Approaches

Abstract

Objective

This article discusses the design, sampling strategy, implementation, and data analytic processes of the DSM-5 Field Trials.

Method

The DSM-5 Field Trials were conducted by using a test-retest reliability design with a stratified sampling approach across six adult and four pediatric sites in the United States and one adult site in Canada. A stratified random sampling approach was used to enhance precision in the estimation of the reliability coefficients. A web-based research electronic data capture system was used for simultaneous data collection from patients and clinicians across sites and for centralized data management. Weighted descriptive analyses, intraclass kappa and intraclass correlation coefficients for stratified samples, and receiver operating curves were computed. The DSM-5 Field Trials capitalized on advances since DSM-III and DSM-IV in statistical measures of reliability (i.e., intraclass kappa for stratified samples) and other recently developed measures to determine confidence intervals around kappa estimates.

Results

Diagnostic interviews using DSM-5 criteria were conducted by 279 clinicians of varied disciplines who received training comparable to what would be available to any clinician after publication of DSM-5. Overall, 2,246 patients with various diagnoses and levels of comorbidity were enrolled, of which over 86% were seen for two diagnostic interviews. A range of reliability coefficients were observed for the categorical diagnoses and dimensional measures.

Conclusions

Multisite field trials and training comparable to what would be available to any clinician after publication of DSM-5 provided “real-world” testing of DSM-5 proposed diagnoses.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 43 - 58
PubMed: 23111546

History

Revision received: 31 August 2012
Accepted: 4 September 2012
Published online: 1 January 2013
Published in print: January 2013
Received: 30 January 2013

Authors

Details

Diana E. Clarke, Ph.D., M.Sc.
From the American Psychiatric Association, Division of Research and American Psychiatric Institute for Research and Education, Arlington, Va.; the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; the Stanford University School of Medicine, Palo Alto, Calif.; and the University of Pittsburgh Medical Center, Pittsburgh, Pa.
William E. Narrow, M.D., M.P.H.
From the American Psychiatric Association, Division of Research and American Psychiatric Institute for Research and Education, Arlington, Va.; the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; the Stanford University School of Medicine, Palo Alto, Calif.; and the University of Pittsburgh Medical Center, Pittsburgh, Pa.
Darrel A. Regier, M.D., M.P.H.
From the American Psychiatric Association, Division of Research and American Psychiatric Institute for Research and Education, Arlington, Va.; the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; the Stanford University School of Medicine, Palo Alto, Calif.; and the University of Pittsburgh Medical Center, Pittsburgh, Pa.
S. Janet Kuramoto, Ph.D., M.H.S.
From the American Psychiatric Association, Division of Research and American Psychiatric Institute for Research and Education, Arlington, Va.; the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; the Stanford University School of Medicine, Palo Alto, Calif.; and the University of Pittsburgh Medical Center, Pittsburgh, Pa.
David J. Kupfer, M.D.
From the American Psychiatric Association, Division of Research and American Psychiatric Institute for Research and Education, Arlington, Va.; the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; the Stanford University School of Medicine, Palo Alto, Calif.; and the University of Pittsburgh Medical Center, Pittsburgh, Pa.
Emily A. Kuhl, Ph.D.
From the American Psychiatric Association, Division of Research and American Psychiatric Institute for Research and Education, Arlington, Va.; the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; the Stanford University School of Medicine, Palo Alto, Calif.; and the University of Pittsburgh Medical Center, Pittsburgh, Pa.
Lisa Greiner, M.S.S.A.
From the American Psychiatric Association, Division of Research and American Psychiatric Institute for Research and Education, Arlington, Va.; the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; the Stanford University School of Medicine, Palo Alto, Calif.; and the University of Pittsburgh Medical Center, Pittsburgh, Pa.
Helena C. Kraemer, Ph.D.
From the American Psychiatric Association, Division of Research and American Psychiatric Institute for Research and Education, Arlington, Va.; the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.; the Stanford University School of Medicine, Palo Alto, Calif.; and the University of Pittsburgh Medical Center, Pittsburgh, Pa.

Notes

Presented in part at the 165th annual meeting of the American Psychiatric Association, Philadelphia, May 5–9, 2012.
Address correspondence to Dr. Clarke ([email protected]).

Funding Information

All authors report no financial relationships with commercial interests.This study was funded by the American Psychiatric Association.

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