The challenge of ensuring affordability, sustainability, consistency, and adaptability in the common metrics agenda.

Mental health research grapples with research waste and stunted field progression caused by inconsistent outcome measurement across studies and clinical settings, which means there is no common language for considering findings. Although recognising that no gold standard measures exist and that all existing measures are flawed in one way or another, anxiety and depression research is spearheading a common metrics movement to harmonise measurement, with several initiatives over the past 5 years recommending the consistent use of specific scales to allow read-across of measurements between studies. For this approach to flourish, however, common metrics must be acceptable and adaptable to a range of contexts and populations, and global access should be as easy and affordable as possible, including in low-income countries. Within a measurement landscape dominated by fixed proprietary measures and with competing views of what should be measured, achieving this goal poses a range of challenges. In this Personal View, we consider tensions between affordability, sustainability, consistency, and adaptability that, if not addressed, risk undermining the common metrics agenda. We outline a three-pronged way forward that involves funders taking more direct responsibility for measure development and dissemination; a move towards managing measure dissemination and adaptation via open-access measure hubs; and transitioning from fixed questionnaires to item banks. We argue that now is the time to start thinking of mental health metrics as 21st century tools to be co-owned and co-created by the mental health community, with support from dedicated infrastructure, coordinating bodies, and funders.

Informations de copyright

Copyright © 2021 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of interests KRK reports personal fees from the International Consortium for Health Outcomes Measurement (ICHOM), outside the submitted work; was a research fellow with ICHOM and supported the development of a core outcome set for children and adolescents experiencing anxiety and depression between Oct 1, 2018, and March 31, 2020; is involved with the International Network for Research Outcomes in Adolescent Depression Studies initiative at the Hospital for Sick Children (Toronto, ON, Canada) that aims to develop a core outcome set specifically for clinical trials of treatmetns for depression in adolescence; and has been serving as an advisor on the Common Measures in Mental Health Science Advisory Committee convened by the International Alliance of Mental Health Research Funders since April, 2021. SC was an employee of ICHOM between June 25, 2018, and Dec 30, 2019, and was responsible for managing the development of core outcome sets in mental health. MdLSF is employed by ICHOM and oversees the development of core outcome sets in mental health. PS reports royalties from Guilford Press for his book A Mind Apart: Understanding Children with Autism and Asperger Syndrome; royalties from Simon & Schuster for his book Start Here: A Parent's Guide to Helping Children and Teens Through Mental Health Challenges; and is a co-investigator for the International Network for Research Outcomes in Adolescent Depression Studies initiative that aims to develop a core outcome set specifically for clinical trials of depression in adolescence. MW is Director of Mental Health at the Wellcome Trust and as such has issued recommendations for common metrics in anxiety and depression research. MW chaired (but not voted at) the aforementioned ICHOM working group that developed core metrics for anxiety and depression in children and young people; was formerly Director of the Child Outcomes Research Consortium that made recommendations about outcome measures; and was involved in developing one of the measures recommended by the ICHOM working group (the Current View tool, which is free to use, and results in no financial gain for the author). The authors did not receive any grant or funding that was specifically dedicated to the preparation of this manuscript.