Assessment of biopsychosocial complexity and health care needs: measurement properties of the INTERMED self-assessment version

Arianne K.B. van Reedt Dortland, Lilian L. Peters, Annette D. Boenink, Jan H. Smit, Joris P.J. Slaets, Adriaan W. Hoogendoorn, Andreas Joos, Corine H.M. Latour, Friedrich Stiefel, Cyrille Burrus, Marie Guitteny-Collas, Silvia Ferrari

Research output: Contribution to journalArticleAcademicpeer-review

22 Citations (Scopus)


OBJECTIVES: The INTERMED Self-Assessment questionnaire (IMSA) was developed as an alternative to the observer-rated INTERMED (IM) to assess biopsychosocial complexity and health care needs. We studied feasibility, reliability and validity of the IMSA within a large and heterogeneous international sample of adult hospital in- and outpatients, and its predictive value for health care utilization (HCU) and quality of life (QoL).

METHODS: 850 participants aged 17 to 90 from 5 countries completed the IMSA and were evaluated with the IM. The following measurement properties were determined: feasibility by percentages of missing values; reliability by Cronbach's alpha; interrater agreement by intraclass correlation coefficients (ICCs); convergent validity of IMSA scores with mental health (SF-36 emotional well-being subscale and HADS), medical health (CIRS) and QoL (EQ-5D) by Spearmans rank correlations; predictive validity of IMSA scores with HCU and QoL by (generalized) linear mixed models.

RESULTS: Feasibility, face validity and reliability (Cronbach's alpha 0.80) were satisfactory. ICC between IMSA and IM total scores was .78 (95% CI .75-.81). Correlations of the IMSA with the SF-36, HADS, CIRS and EQ-5D (convergent validity) were -.65, .15, .28 and -.59, respectively. The IMSA significantly predicted QoL and also HCU (emergency room visits, hospitalization, outpatient visits, and diagnostic exams) after 3 and 6 months follow-up. Results were comparable between hospital sites, in- and outpatients, and age groups.

CONCLUSION: The IMSA is a generic and time-efficient method to assess biopsychosocial complexity and to provide guidance for multidisciplinary care trajectories in adult patients, with good reliability and validity across different cultures.

Original languageEnglish
Pages (from-to)485-492
Number of pages8
JournalPsychosomatic medicine
Issue number4
Publication statusPublished - 1 May 2017


  • Biopsychosocial complexity
  • Health care needs
  • Health care use
  • Integrated care
  • Multidisciplinary care
  • Quality of life

Cite this