The empirical evidence base for the use of the HCR-20: A narrative review of study designs and transferability of results to clinical practice

Challinor, Alexander ORCID: 0000-0001-7305-0007, Ogundalu, Abisola, McIntyre, Jason C, Bramwell, Vicky and Nathan, Rajan (2021) The empirical evidence base for the use of the HCR-20: A narrative review of study designs and transferability of results to clinical practice. International Journal of Law and Psychiatry, 78. p. 101729.

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Abstract

The HCR-20, a widely used method of assessing and managing risk, relies on the structured professional judgement approach. This paper reports a narrative literature review of the HCR-20 studies to explore the applicability of the study results to the use of the HCR-20 in clinical practice. From a literature search using terms "HCR-20" and "HCR 20", 206 papers were included. Of studies using the HCR-20 version 2 (n = 191), 92% (n = 176) relied on variables based on scores derived by adding item scores, and 50% (n = 95) tested the HCR-20 using predictive validity methodology. Of the HCR-20 version 3 studies (n = 21), the "presence of risk factors" step was the most commonly examined (n = 18, 86%), but 2 of the 7 steps ("scenario planning" and "management") were not examined at all. Amongst those studies whose primary focus was on the HCR-20, 67% (n = 64/95) did so by assessing the predictive validity of the tool. Only one employed a design to test whether the use of the HCR-20 affected violence rates. The predominant study design provides support for the use of the HCR-20 as an actuarial tool, and there is limited empirical evidence in support of its effectiveness as a structured professional judgement approach to the assessment and management of the risk of violence.

Item Type:	Article
Uncontrolled Keywords:	Risk assessment, risk management, HCR-20, structured professional judgement, actuarial, predictive validity, threat assessment
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Clinical Directorate
Depositing User:	Symplectic Admin
Date Deposited:	27 Sep 2021 07:12
Last Modified:	18 Jan 2023 21:28
DOI:	10.1016/j.ijlp.2021.101729
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3138292