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Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM)


What it is​

The CORE-OM (Clinical Outcomes Routine Evaluation – Outcome Measure) is a self-report measure, providing an index of global distress. The measure is helpful in capturing a variety of mental health difficulties, beyond typical symptom measures Scores from set items can also provide a severity of psychological distress across four dimensions:

  • Problems / symptoms (mental health issues such as symptoms of depression and anxiety)
  • Life functioning (social, interpersonal and general functioning in daily life)
  • Subjective wellbeing (an individual’s sense of life quality and emotional health)
  • Risk / harm (risk to self and to others)

The four risk items should be used as clinical flags rather than a scale and can be used to help identify risk and generate discussion with patients. The measure is suitable as an initial screening tool and can be used to assess change following treatment.

How is it used​

  • Can be used with adults (18yrs+)
  • Takes approximately 5mins to complete
  • Asks about psychological distress over the last week
  • Often used at the beginning and end of therapy
  • CORE-10 is used during ongoing therapy and total scores from the CORE-10 and CORE-OM directly compared

What do the scores mean?​

The CORE-OM has 34 items, with all items using the same five level response from 0 (not at all) to 4 (most of the time). The questionnaire is completed in relation to the past 7 days and provides a total score of distress and scores across the four areas of wellbeing, problems, functioning and risk. Of the items assessing risk, 2 items address risk to self (harm to self and suicidal ideation) and 2 items assess risk to others (violent behaviour and threats towards others). The total score and subscale scores are scored between 0 and 40 with higher scores reflecting worse distress and are categorised across six levels of severity:

  • Healthy (score of 0 to 6)
  • Low severity (score of 7 to 10)
  • Mild severity (score of 11 of 15)
  • Moderate severity (score of 16 to 20)
  • Moderate to severe severity (score of 21 to 25)
  • Severe severity (score of 26 to 40)

A clinical cut off score of 10 has been recommended with a reliable change index score of 5 points for any change to be classed as reliable. When administered more than once, trends can be viewed across the provided scores to assess change over time.

Developer​

The copyright holder for the CORE-OM is the CORE System Trust

References:

Evans et al., (2000). CORE: Clinical Outcomes in Routine Evaluation. Journal of Mental Health, 9: 247–255

Evans et al., (2002). Towards a standardised brief outcome measure: Psychometric properties and utility of the CORE-OM. British Journal of Psychiatry, 180: 51–60

Connell et al., (2007). Distribution of CORE-OM scores in a general population, clinical cut-off points and comparison with the CIS-R. British Journal of Psychiatry, 190: 69–74