CORE 3: FUNCTIONAL OUTCOME AND SYMPTOM ASSESSMENT The primary goal of this Core (FOSAC) is to provide specialized training and quality assurance procedtires for assessing functional outcome, insight, diagnosis, and psychiatric symptoms to projects and cores within the Center. FOSAC will train raters to assess patients across 3 phases of illness in the Prodromal Project, the Aftercare Core, and the Chronic Core. FOSAC will be responsible for establishing and maintaining high levels of interrater reliability, preventing rater drift, and improving the reliability and validity of Center measures. To accomplish these goals, FOSAC will: 1) maintain well-standardized, and comprehensive training and quality assurance methods for assessing functional outcome, insight, prodromal signs, diagnosis of DSM-IV disorders, and psychiatric symptoms, 2) maintain reliability standards and criteria for certification of raters who use assessment instruments such as the CAF, MODSAS, GSRFS, SUMD-R, SCID-I, SCID-II, SIPS, BPRS, SANS, and SAPS, 3) ensure high levels of interrater reliability for trainers who will be conducting assessment procedures, and 4) expand FOSAC training videotape library to include updated training interviews. Phase 1 of training requires the rating of a minimum of 6 training videotapes and having interrater reliability calculated using the accompanying """"""""Gold Standard"""""""" consensus ratings. For categorical ratings, a minimum overall kappa is required of .80 (kappa sensitivity of .80 and kappa specificity of .80). For dimensional ratings, the trainee is required to achieve a minimum Interdass Correlation Coefficient (ICC) of .80. These requirements must be met before progressing to Phase 2 which requires thatthe rater conduct 4 """"""""live"""""""" assessments for each measure. In Phase 2, the FOSAC will formally evaluate the interviewer's ability to conduct the interview. If the requirements arenotmet, the trainee will be required to attend remediation sessions before """"""""graduating"""""""" to Phase 2. All raters will enter Phase 3, a QA Program aimed at preventing rater """"""""drift"""""""" FOSAC will collaborate with other Cores for Clinical Samples and Projects around research questions such as instrument development, method development, and improving interrater reliability.
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