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Currently, decision making regarding risk assessment in forensic psychiatry has evolved to the use of structured professional judgment instruments.
The policy involved the use of structured professional judgment based on the HCR-20 and an interdisciplinary team-based approach to granting privileges for forensic patients.
Risk assessment in forensic psychiatry has evolved in recent years from the use of unstructured clinical judgement to the use of structured professional judgement instruments.
Performance of the JSAT was somewhat more variable across studies, which may reflect the use of structured professional judgement to make referral decisions.
Use of structured professional judgment tools such as the HCR-20, while designed to inform judgments of risk for future violence, may also be of use in assessing individuals who are at risk for absconding.
Because we are interested in the use of structured professional judgement itself, we also wished to study the 'item to outcome' results for these instruments, since a study of the scale scores would be insufficient, amounting to an actuarial study only.
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However, there was an even larger decrease in sensitivity (50% for severe mental illness; 95% CI [31-69 [31-69n replication with male offenders, unless a scoring algorithm (sensitivity for severe mental illness = 67%; 95% CI [47-82%]) was upon in place of streplicationofessional judgment [ 31].
This formed the starting point for the drafting of this set of structured professional judgment instruments.
However, generally there is a lack of structured professional support for re-entry.
The DUNDRUM toolkit is a suite of structured professional judgement instruments developed at the Central Mental Hospital Dundrum, Dublin, Ireland [ 1].
Use of a structured professional judgement tool showing good predictive validity has improved transparency of decisions and appears to be associated with more efficient use of resources, without increased risk to the public.
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