Psychosocial Assessment of Transplant Candidates: Inter-rater Reliability and Concurrent Validity of the Japanese Version of the Stanford Integrated Psychosocial Assessment for Transplantation

Ito, Satoko; Oshibuchi, Hidehiro; Tsutsui, Junko; Kobayashi, Sayaka; Takano, Kosuke; Sugawara, Hiroko; Kamba, Rumiko; Akaho, Rie; Ishida, Hideki; Maldonado, José R.; Nishimura, Kazuhiko

doi:10.1016/j.jaclp.2021.10.004

Cited by 6 publications

(9 citation statements)

References 38 publications

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“…[44] Indeed, translated versions of SIPAT have revised the (a3) question after conducting expert panels and cognitive testing to prevent bias. [19] Questions assessing knowledge and understanding of illness and transplant (a1/a2) are similarly susceptible to bias and may disadvantage nonnative English speakers and patients with limited health literacy. Given the potential for exacerbating disparities, using established guidelines [27,28,34,40] to assess question-level bias and revising accordingly should be a priority for future validation efforts.…”

Section: Discussionmentioning

confidence: 99%

“…In another study, clinicians inaccurately estimated psychiatric patients’ treatment motivation and disproportionately rated ethnic minority patients as less motivated 44 . Indeed, translated versions of SIPAT have revised the (a3) question after conducting expert panels and cognitive testing to prevent bias 19 . Questions assessing knowledge and understanding of illness and transplant (a1/a2) are similarly susceptible to bias and may disadvantage non-native English speakers and patients with limited health literacy.…”

Section: Discussionmentioning

confidence: 99%

“…One study 9 found strong correlations between SIPAT and The Psychosocial Assessment of Candidates for Transplant, 15 demonstrating concurrent criterion validity. Validation studies for translated versions (107 ≤ N ≤ 150) found high inter-rater reliability, 16–19 moderate concurrent validity, 19 and good internal consistency 16,18 . However, a recent prospective single-center study (N = 173) 14 found bias across groups and mixed construct validity.…”

Section: Introductionmentioning

confidence: 99%

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Assessing reliability and validity of SIPAT and opportunities for improvement: A single-center cohort study

Perry,

Deutsch-Link,

Marfeo

et al. 2023

Liver Transplantation

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Psychosocial assessment is a standard component of patient evaluations for transplant candidacy. The Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) is a widely used measure to assess psychosocial risk for transplant. However, there are questions regarding the SIPAT's reliability and validity. We examined the SIPAT’s psychometric performance and its impact on equitable access to transplant in a diverse cohort of 2825 patients seeking liver transplantation between 2014 and 2021 at an urban transplant center. The SIPAT demonstrated good internal consistency reliability at the overall score [Cronbach’s α = 0.85, 95% CI (0.83, 0.86)] and domain levels (0.80 > α > 0.70). There was mixed support for structural validity, with poor overall model fit in confirmatory factor analysis and 50% of questions achieving the 0.70-factor loadings threshold. Adjusting for sociodemographic variables, the odds of not being waitlisted for psychosocial reasons were three times higher for patients with Medicaid insurance than patients with private insurance [OR 3.24, 95% CI (2.09, 4.99)] or Medicare [OR 2.89, 95% CI (1.84, 4.53)], mediated by higher SIPAT scores. Black patients had nearly twice the odds of White patients [OR 1.88, 95% CI (1.20, 2.91)], partially mediated by higher social support domain scores. Patients with Medicaid, non-White patients, and those without a college degree scored significantly higher on collinear questions, disproportionately contributing to higher SIPAT scores. The SIPAT did not perform equally across insurance type, race/ethnicity, and education groups, with the lowest subgroup validity associated with patient readiness and psychopathology domains. The SIPAT should be interpreted with caution, especially as a composite score. Future studies should examine validity in other populations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessing reliability and validity of SIPAT and opportunities for improvement: A single-center cohort study

Perry,

Deutsch-Link,

Marfeo

et al. 2023

Liver Transplantation

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“…Therefore, psychosocial assessment of organ recipients is an integral part of the pre-transplant evaluation process, and the results can be expected to help predict post-transplant outcomes. Pre-transplant psychosocial evaluation to accurately assess the risk of post-transplant outcomes should be comprehensive, including the assessment of cognitive, behavioral, psychological, and social risk factors that may influence the transplant process and post-transplant outcomes [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…The SIPAT has been translated into Spanish, Italian, and Thai; all have demonstrated excellent inter-rater reliability and internal consistency [ 21 , 26 , 27 ]. We, therefore, translated the SIPAT into Japanese, validated its inter-rater reliability and internal consistency, and created a Japanese version of SIPAT (SIPAT-J) [ 6 ]. The SIPAT was designed to standardize the psychosocial assessment of transplant recipient candidates and to quantify the appropriateness of various transplants.…”

Section: Introductionmentioning

confidence: 99%

Characterization of the stanford integrated psychosocial assessment for transplant for heart, liver, and kidney transplant candidates in Japan

Takano

Oshibuchi

Kobayashi

et al. 2023

BioPsychoSocial Med

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Background The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is a comprehensive psychosocial assessment proven useful for predicting the outcomes of organ transplantation that is expected to be useful in Japan. However, the characteristics of organ-specific SIPAT scores for organ transplant recipient candidates in Japan are unclear and, to date, the SIPAT has not been properly utilized in clinical practice. The purpose of this study was to present basic data that can be used to establish the relation between SIPAT scores and post-transplantation psychosocial outcomes as well as organ-specific outcomes. Methods This study included 167 transplant recipient candidates (25 heart, 71 liver, and 71 kidney) who completed a semi-structured interview based on the Japanese version of SIPAT (SIPAT-J) prior to transplantation. The differences between organs in terms of SIPAT scores and differences in SIPAT scores based on demographic data were comparatively analyzed. Results The total SIPAT scores were higher for liver recipient candidates than for heart recipient candidates (P = .019). Regarding the subscales, SIPAT B (social support system) scores were higher for liver and kidney recipient candidates than for heart recipient candidates (P = .021), whereas SIPAT C (psychological stability and psychopathology) scores were higher for liver recipient candidates than for kidney recipient candidates (P = .002). Recipient candidates with a history of psychiatric treatment and those who were unemployed had higher SIPAT scores, regardless of the transplant organ, than recipient candidates without a history of psychiatric treatment and those who were employed (P < .001, P = .016, respectively). Conclusions There were notable differences in the total SIPAT-J and subscale scores among the liver, heart, and kidney recipient candidates. Each organ was associated with specific psychosocial issues that should be addressed before transplantation. Interventions such as information provision and patient education based on SIPAT assessment results for each organ may improve recipient post-transplant outcomes.

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Association of the Stanford Integrated Psychosocial Assessment for Transplant and 1-Year Outcome of Living Kidney Transplantation in Japan

Takano,

Kobayashi,

Oshibuchi

et al. 2024

Journal of the Academy of Consultation-Liaison Psychiatry

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Psychosocial Assessment of Transplant Candidates: Inter-rater Reliability and Concurrent Validity of the Japanese Version of the Stanford Integrated Psychosocial Assessment for Transplantation

Cited by 6 publications

References 38 publications

Assessing reliability and validity of SIPAT and opportunities for improvement: A single-center cohort study

Assessing reliability and validity of SIPAT and opportunities for improvement: A single-center cohort study

Characterization of the stanford integrated psychosocial assessment for transplant for heart, liver, and kidney transplant candidates in Japan

Association of the Stanford Integrated Psychosocial Assessment for Transplant and 1-Year Outcome of Living Kidney Transplantation in Japan

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