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All four data element sets performed well, but the mental status data elements were deemed burdensome to complete

• In terms of feasibility, missing data were very low for all four tested data elements, and there was minimal variability in time to complete.
• Interrater reliability was excellent for all data elements.
• The majority of patients/residents did not exhibit significant change in their symptoms of depression, anxiety, and pain during their stay. Among those patients/residents who did exhibit change from admission to discharge, their symptoms improved over the course of the PAC stay, which implies that assessment of symptoms of depression, anxiety, and pain may be most informative at both admission and discharge.
• Feedback from the clinical assessors in the National Beta Test indicated that the Pain Interview data elements had high clinical utility and reasonably low burden, whereas the mental status data elements had moderate clinical utility and relatively high data collection and patient burden.

The Centers for Medicare & Medicaid Services (CMS) contracted with the RAND Corporation to evaluate candidate standardized patient assessment data elements (SPADEs) in a national field test titled the National Beta Test. The National Beta Test was conducted to evaluate the performance of candidate SPADEs in the clinical categories of (1) cognitive function and mental status; (2) special services, treatments, and interventions; (3) medical conditions and comorbidities; (4) impairments; and (5) other categories, for use in four post-acute care (PAC) settings: home health agencies, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities.

This is Volume 5 of the final report on the National Beta Test. It describes the identification and testing of candidate SPADEs in the clinical categories of mental status and pain. This volume provides results and significance tests on the feasibility, reliability, validity, stability and change over time, and sensitivity to national representativeness of the candidate SPADEs. The mental status data elements tested consisted of the Patient Health Questionnaire (PHQ)-2 to 9, Patient Reported Outcome Measurement Information System (PROMIS) Depression, and PROMIS Anxiety. The pain data element set tested was the Pain Interview. All four data element sets performed fairly well, showing feasibility, acceptable reliability, and moderate support from assessors.

• Chapter One

  Introduction

• Chapter Two

  Standardized Assessment of Mental Status and Pain

• Chapter Three

  PHQ-2 to 9

• Chapter Four

  PROMIS Depression

• Chapter Five

  PROMIS Anxiety

• Chapter Six

  Pain Interview

• Chapter Seven

  Conclusion

• Appendix

  Supplementary Tables