[The IREPRO List of Indicators--a tool for systematic evaluation of the prognosis for reintegration and the need for rehabilitation in the course of psychiatric disability pension assessment]

Abstract

There is little research on the process of decision making in sociomedical expert opinion especially on prognostic issues. Experts therefore have to rely upon experience and their own routines of judgement. The IREPRO List of Indicators offers a systematic scheme for the sociomedical exploration and evaluation of the prognosis for reintegration and the need for rehabilitation in claimants for disability pension due to mental illness. A set of ten indicators was defined and its practical use tested in an expert-based process of development. In a manual each indicator is thoroughly described in a standardized manner including a five-point rating scale. In a profile sheet the ratings of all ten indicators are visualized, appropriate therapeutical and rehabilitative means are assigned, and the final judgement of prognosis is deduced. At present the IREPRO List of Indicators offers a good tool to structure the process of decision making and contributes to enhancing transparency and uniformity of the process. It can also be used to discuss cases among colleagues. The basic principle can be transferred to other fields of sociomedical expert opinion-building. The article describes requirements and difficulties in psychiatric disability assessment, the list of indicators and experiences gained from the process of development.