Improving the Accuracy and Reliability of Ratings on the Hamilton Depression Rating Scale via a Video‐Based Training Program

Introduction The clinician‐rated 17‐item Hamilton Depression Rating Scale (HAM‐D17) allows for a systematic severity assessment of depressive symptoms. Applying the HAM‐D17 in clinical practice requires that staff members' ratings on the HAM‐D17 are accurate and reliable. Here, we aimed to investigate whether such accuracy and reliability can be achieved through a brief video‐based training program. Methods One‐hundred‐and‐ten psychiatric hospital staff members (psychologists, medical doctors, nurses, health care workers, physio‐/occupational therapists, and social workers) performed baseline HAM‐D17 ratings after watching a videotaped patient interview. Subsequently, a theoretical introduction video was displayed, followed by five successive videotaped patient interviews. After watching each interview, individual ratings were conducted before a video providing the gold standard rating was displayed. Accuracy was estimated by calculating the proportion of participants whose ratings did not display a deviation from the gold standard of > 1 point on all individual HAM‐D17 items and > 6 points on the HAM‐D17 total score. Reliability was calculated using Gwet's agreement coefficient (AC1). Results At baseline and after the sixth rating session, 43% versus 70% of the staff members, respectively, rated within the acceptable deviation of the gold standard ( p < 0.001). At the HAM‐D17 item level, baseline reliability indices were highest for item 6 (Late Insomnia) and lowest for item 14 (Sexual Interest) (AC1 = 0.97 vs. 0.47), but both improved following training (AC1 = 0.99 vs. 0.84 at the sixth rating session). Conclusions Most staff members conducted accurate and reliable HAM‐D17 ratings after participating in a brief video‐based training program.