Adding a functional utility score to the evaluation of behavioral health screens in integrated care settings: What's all the FUS about?

As healthcare delivery is rapidly changing, the rise of integrated care systems is becoming more prominent. A vital pathway of care in these new integrated care systems is the screening and identification of behavioral health issues through the use of efficient and valid behavioral health screens. While research examining the utility of these screens tends to focus on traditional psychometric properties, such as sensitivity and specificity, these fail to measure how well these screens will generalize to medical settings outside the research context. This leads to the creation of behavioral health screens that have adequate psychometric properties but questionable functional utility in the medical setting. The current paper provides a justification and framework for examining the concept of a “functional utility score” (FUS), which assesses a screen's ability to be useful within its intended system of care. The use of such a metric can improve research on behavioral health screens, and ensure that new measures will be able to meet the needs of the integrated care setting.