Understanding Clinical Metrics and How We Use Them at Daybreak

An Introduction to the Assessments Daybreak Uses

The Daybreak team uses several well-known and respected assessments as screening tools to measure the severity of symptoms, to aid in the diagnosis of anxiety and/or depression, and as a symptom tracking tool that can help track the severity and improvement of specific symptoms—or lack thereof—with treatment.

The assessments used are the GAD-7, PHQ-9, and WHO-5. Here’s how they work:

The Generalized Anxiety Disorder Assessment (GAD-7) is a seven-item instrument that is used to measure or assess the severity of generalized anxiety disorder (GAD). Each item asks the individual to rate the severity of their symptoms over the past two weeks. Response options include “not at all”, “several days”, “more than half the days” and “nearly every day.”

The Patient Health Questionnaire (PHQ-9) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as “0” (not at all) to “3” (nearly every day).

The World Health Organization Well-Being Index (WHO-5) is amongst the most widely used questionnaires that assesses subjective psychological well-being. Since its first publication in 1998, the WHO-5 has been translated into more than 30 languages and has been used in research studies all over the world. We now provide a systematic review of the literature on the WHO-5.

How the Daybreak Team Collects and Reviews the Data 

When we are onboarding a new client, we take a baseline assessment to understand the severity of their symptoms and what they are struggling with the most. Every two weeks, the client will retake the assessment. They will be reminded to take this in the Daybreak app and can complete the assessment in the app as well. The results are then uploaded to the Clinician’s Dashboard and the client’s EHR file. Here’s an example of how the tracking looks over time: 

Here’s how we interpret each of these assessments:  

Interpreting the GAD-7

Interpreting the PHQ-9

Interpreting the WHO-5 (multiply the total number reported by 4 to get scores that are measured out of 100)

  • Poor Well-being: 0-30
  • Moderate Well-being: 31-69
  • Good Well-being: 70 +

The total raw score, ranging from 0 to 25, is multiplied by 4 to give the final score, with 0 representing the worst imaginable well-being and 100 representing the best imaginable well-being.

Using the Data in Therapeutic Sessions

This data is essential for the treating clinician to get real-time results and adjust or focus their treatment direction. These ongoing results allow the clinician to better understand how the client has been over the previous 2 weeks and they can review overall progress during the course of treatment.

The consistent data also helps to establish what has been working and what has not, identify continued areas for improvement or support, especially during triggering or challenging times during the course of treatment, and provide in-session discussion topics.

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