{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:58:38Z","timestamp":1791892718105,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["16\/96\/09"],"award-info":[{"award-number":["16\/96\/09"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acamh.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child Psychology Psychiatry"],"published-print":{"date-parts":[[2025,6]]},"abstract":"\n Background<\/jats:title>\n Standardised Diagnostic Assessment tools, such as the Development and Well\u2010Being Assessment (DAWBA), may aid detection and diagnosis of emotional disorders but there is limited real\u2010world evidence of their clinical or cost effectiveness.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a multicentre, two\u2010arm parallel group randomised controlled trial in eight large National Health Service Trusts in England providing multidisciplinary specialist Child and Adolescent Mental Health Services (CAMHS). Participants (5\u201317\u2009year\u2010olds with emotional difficulties referred to CAMHS) were randomly assigned (1:1), following referral receipt, to either receive the DAWBA and assessment\u2010as\u2010usual (intervention group) or assessment\u2010as\u2010usual (control group). Data were self\u2010reported by participants (parents and\/or young person, depending on age) at baseline, 6\u2010 and 12\u2010month post\u2010randomisation and collected from clinical records up to 18\u2009months post\u2010randomisation. The primary outcome was a clinician\u2010made diagnosis decision about the presence of an emotional disorder within 12\u2009months of randomisation. Trial registration: ISRCTN15748675.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In total, 1,225 children and young people (58% female sex) were randomised (615 intervention; 610 control). Adherence to the intervention (full\/partial completion) was 80% (494\/615). At 12\u2009months, 68 (11%) participants in the intervention group received an emotional disorder diagnosis versus 72 (12%) in the control group (adjusted risk ratio (RR) 0.94 [95% CI 0.70, 1.28]). The intervention was not cost effective. There was no evidence of any differences between groups for service\u2010related or participant\u2010reported secondary outcomes, for example, CAMHS acceptance of the index referral (intervention 277 (45%) versus control 262 (43%); RR: 1.06 [95% CI: 0.94, 1.19]) was similar between groups.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n As delivered in this pragmatic trial, we found no evidence for the effectiveness or cost effectiveness of using a Standardised Diagnostic Assessment tool in aiding the detection of emotional disorders or clinical outcomes in clinically referred children and young people. Despite regular efforts to encourage clinicians to view the DAWBA report and consider its findings as part of assessment and diagnosis, we did not collect data on usage and therefore cannot confirm the extent to which clinicians did this. As a pragmatic trial that aimed to test the effectiveness of incorporating the DAWBA into usual practice and clinical care, our study found that, in the format as delivered in this trial, there was no impact on diagnosis or clinical outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jcpp.14090","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T19:01:24Z","timestamp":1736276484000},"page":"805-820","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["The clinical and cost effectiveness of a\n STAndardised DIagnostic<\/scp>\n Assessment for children and adolescents with emotional difficulties: the STADIA multi\u2010centre randomised controlled trial"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2050-4316","authenticated-orcid":false,"given":"Kapil","family":"Sayal","sequence":"first","affiliation":[{"name":"Unit of Mental Health & Clinical Neurosciences, School of Medicine University of Nottingham Nottingham UK"},{"name":"Institute of Mental Health Nottinghamshire Healthcare NHS Foundation Trust Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Wyatt","sequence":"additional","affiliation":[{"name":"Nottingham Clinical Trials Unit, School of Medicine University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Partlett","sequence":"additional","affiliation":[{"name":"Nottingham Clinical Trials Unit, School of Medicine University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Ewart","sequence":"additional","affiliation":[{"name":"STADIA Patient and Public Involvement Co\u2010Lead Institute of Mental Health, University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anupam","family":"Bhardwaj","sequence":"additional","affiliation":[{"name":"Unit of Mental Health & Clinical Neurosciences, School of Medicine University of Nottingham Nottingham UK"},{"name":"Cambridgeshire and Peterborough NHS Foundation Trust Cambridge UK"},{"name":"School of Medicine University of Cambridge Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernadka","family":"Dubicka","sequence":"additional","affiliation":[{"name":"Hull and York Medical School University of York York UK"},{"name":"Greater Manchester Mental Health Trust Manchester UK"},{"name":"Pennine Care NHS Foundation Trust Ashton\u2010under\u2010Lyne UK"},{"name":"Manchester Academic Health Sciences, Faculty of Biology Medicine and Health University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamsin","family":"Marshall","sequence":"additional","affiliation":[{"name":"Berkshire Healthcare NHS Foundation Trust Bracknell UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Gledhill","sequence":"additional","affiliation":[{"name":"Central and North West London NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Lang","sequence":"additional","affiliation":[{"name":"Human Factors Research Group, Faculty of Engineering University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsty","family":"Sprange","sequence":"additional","affiliation":[{"name":"Nottingham Clinical Trials Unit, School of Medicine University of Nottingham Nottingham 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