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Articles by T Ford
Total Records ( 4 ) for T Ford
  T Ford , J Hutchings , T Bywater , A Goodman and R. Goodman
 

Background

Routine outcome monitoring may improve clinical services but remains controversial, partly because the absence of a control group makes interpretation difficult.

Aims

To test a computer algorithm designed to allow practitioners to compare their outcomes with epidemiological data from a population sample against data from a randomised controlled trial, to see if it accurately predicted the trial's outcome.

Method

We developed an `added value' score using epidemiological data on the Strengths and Difficulties Questionnaire (SDQ). We tested whether it correctly predicted the effect size for the control and intervention groups in a randomised controlled trial.

Results

As compared with the a priori expectation of zero, the Added Value Score applied to the control group predicted an effect size of –0.03 (95% CI –0.30 to 0.24, t = 0.2, P = 0.8). As compared with the trial estimate of 0.37, the Added Value Score applied to the intervention group predicted an effect size of 0.36 (95% CI 0.12 to 0.60, t = 0.1, P = 0.9).

Conclusions

Our findings provide preliminary support for the validity of this approach as one tool in the evaluation of interventions with groups of children who have, or are at high risk of developing, significant psychopathology.

  D Wolke , A Waylen , M Samara , C Steer , R Goodman , T Ford and K. Lamberts
 

Background

Participant drop-out occurs in all longitudinal studies, and if systematic, may lead to selection biases and erroneous conclusions being drawn from a study.

Aims

We investigated whether drop out in the Avon Longitudinal Study of Parents And Children (ALSPAC) was systematic or random, and if systematic, whether it had an impact on the prediction of disruptive behaviour disorders.

Method

Teacher reports of disruptive behaviour among currently participating, previously participating and never participating children aged 8 years in the ALSPAC longitudinal study were collected. Data on family factors were obtained in pregnancy. Simulations were conducted to explain the impact of selective drop-out on the strength of prediction.

Results

Drop out from the ALSPAC cohort was systematic and children who dropped out were more likely to suffer from disruptive behaviour disorder. Systematic participant drop-out according to the family variables, however, did not alter the association between family factors obtained in pregnancy and disruptive behaviour disorder at 8 years of age.

Conclusions

Cohort studies are prone to selective drop-out and are likely to underestimate the prevalence of psychiatric disorder. This empirical study and the simulations confirm that the validity of regression models is only marginally affected despite range restrictions after selective drop-out.

  K Langley , T Fowler , T Ford , A. K Thapar , M van den Bree , G Harold , M. J Owen , M. C O'Donovan and A. Thapar
 

Background

Attention-deficit hyperactivity disorder (ADHD) is recognised as a common, disabling condition. Little information is available regarding the long-term outcomes for individuals with ADHD in the UK.

Aims

To examine the 5-year outcome for a UK cohort of children with diagnosed, treated ADHD and identify whether maternal and social factors predict key outcomes.

Method

One hundred and twenty-six school-aged children (mean age 9.4 years, s.d. = 1.7) diagnosed with ADHD were reassessed 5 years later during adolescence (mean age 14.5 years, s.d. = 1.7) for ADHD, conduct disorder and other antisocial behaviours.

Results

Most adolescents (69.8%) continued to meet full criteria for ADHD, were known to specialist services and exhibited high levels of antisocial behaviour, criminal activity and substance use problems. Maternal childhood conduct disorder predicted offspring ADHD continuity; maternal childhood conduct disorder, lower child IQ and social class predicted offspring conduct disorder symptoms.

Conclusions

The treatment and monitoring of ADHD need to be intensified as outcomes are poor especially in offspring of mothers with childhood conduct disorder symptoms.

  S. P Singh , M Paul , T Ford , T Kramer , T Weaver , S McLaren , K Hovish , Z Islam , R Belling and S. White
 

Background

Many adolescents with mental health problems experience transition of care from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS).

Aims

As part of the TRACK study we evaluated the process, outcomes and user and carer experience of transition from CAMHS to AMHS.

Method

We identified a cohort of service users crossing the CAMHS/AMHS boundary over 1 year across six mental health trusts in England. We tracked their journey to determine predictors of optimal transition and conducted qualitative interviews with a subsample of users, their carers and clinicians on how transition was experienced.

Results

Of 154 individuals who crossed the transition boundary in 1 year, 90 were actual referrals (i.e. they made a transition to AMHS), and 64 were potential referrals (i.e. were either not referred to AMHS or not accepted by AMHS). Individuals with a history of severe mental illness, being on medication or having been admitted were more likely to make a transition than those with neurodevelopmental disorders, emotional/neurotic disorders and emerging personality disorder. Optimal transition, defined as adequate transition planning, good information transfer across teams, joint working between teams and continuity of care following transition, was experienced by less than 5% of those who made a transition. Following transition, most service users stayed engaged with AMHS and reported improvement in their mental health.

Conclusions

For the vast majority of service users, transition from CAMHS to AMHS is poorly planned, poorly executed and poorly experienced. The transition process accentuates pre-existing barriers between CAMHS and AMHS.

 
 
 
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