The clinical effectiveness of cognitive therapy for depression in an outpatient clinic
Open accessAbstract
Background Cognitive therapy (CT) has been shown to be efficacious in the treatment of depression in numerous randomized controlled trials (RCTs). However, little evidence is available that speaks to the effectiveness of this treatment under routine clinical conditions. Method This paper examines outcomes of depressed individuals seeking cognitive therapy at an outpatient clinic (N=217, Center for Cognitive Therapy; CCT). Outcomes were then compared to those of participants in a large NIMH-funded RCT of cognitive therapy and medications as treatments for depression. Results The CCT is shown to be a clinically representative setting, and 61% of participants experienced reliable change in symptoms over the course of treatment; of those, 45% (36% of the total sample) met criteria for recovery by the end of treatment. Participants at CCT had similar outcomes to participants treated in the RCT, but there was some evidence that those with more severe symptoms at intake demonstrated greater improvement in the RCT than their counterparts at CCT. Limitations The CCT may not be representative of all outpatient settings, and the structure of treatment there was considerably different from that in the RCT. Treatment fidelity was not assessed at CCT. Conclusions Depressed individuals treated with cognitive therapy in a routine clinical care setting showed a significant improvement in symptoms. When compared with outcomes evidenced in RCTs, there was little evidence of superior outcomes in either setting. However, for more severe participants, outcomes were found to be superior when treatment was delivered within an RCT than in an outpatient setting. Clinicians treating such patients in non-research settings may thus benefit from making modifications to treatment protocols to more closely resemble research settings.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
RCTs include procedures that are often very different from the delivery of interventions in routine practice.
“While RCTs are accepted as the 'gold standard' for intervention research, they include procedures that are often very different to the delivery of the interventions in routine practice (Gibbons et al ., 2010).”
From Supervisor practice when guiding therapists working with depression: The impact of supervisor and patient characteristics (2018) · cites this paper as Gibbons et al ., 2010
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032 · see citing works
Self-citationCohen, J. (1992) · Psychological Bulletin · doi:10.1037//0033-2909.112.1.155 · Cited by 8,771 · see citing works
Jacobson, N. S., & Truax, P. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.59.1.12 · Cited by 7,770 · see citing works
Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients
Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. F. (1996) · Journal of Personality Assessment · doi:10.1207/s15327752jpa6703_13 · Cited by 5,965 · see citing works
Self-citationThe empirical status of cognitive-behavioral therapy: A review of meta-analyses
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006) · Clinical Psychology Review · doi:10.1016/j.cpr.2005.07.003 · Cited by 3,215 · see citing works
Self-citationDefining empirically supported therapies.
Chambless, D. L., & Hollon, S. D. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.66.1.7 · Cited by 3,067 · cited 1× · see citing works
“Based on RCT evidence, a number of psychosocial treatments have been designated as “empirically supported therapies” (ESTs) (Chambless and Hollon, 1998).”
BackgroundDefining empirically supported therapies.
Chambless, D. L., & Hollon, S. D. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.66.1.7 · Cited by 3,067 · see citing works
Elkin, I. (1989) · Archives of General Psychiatry · doi:10.1001/archpsyc.1989.01810110013002 · Cited by 2,300 · see citing works
The effectiveness of psychotherapy: the Consumer Reports study
Seligman, M. E. P. (1995) · American Psychologist · doi:10.1037/0003-066x.50.12.965 · Cited by 1,608 · cited 1× · see citing works
“The RCT methodology is well accepted as the “gold standard” for establishing efficacy (Seligman, 1995, p. 966).”
MethodThe effectiveness of psychotherapy: The Consumer Reports study.
Seligman, M. E. P. (1995) · American Psychologist · doi:10.1037//0003-066x.50.12.965 · Cited by 1,591 · see citing works
A psychometric evaluation of the Beck Depression Inventory–II.
Dozois, D. J. A., Dobson, K. S., & Ahnberg, J. L. (1998) · Psychological Assessment · doi:10.1037/1040-3590.10.2.83 · Cited by 1,517 · see citing works
Westen, D., Novotny, C. M., & Thompson-Brenner, H. (2004) · Psychological Bulletin · doi:10.1037/0033-2909.130.4.631 · Cited by 1,212 · see citing works
Psychotherapy for depression in adults: A meta-analysis of comparative outcome studies.
Cuijpers, P., van Straten, A., Andersson, G., & van Oppen, P. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0013075 · Cited by 1,050 · cited 2× · see citing works
“The efficacy of cognitive therapy (CT) in the treatment of many psychiatric disorders, including depression, has been established in a large number of randomized clinical trials (RCTs; Cuijpers et al., 2008; Butler et al., 2006; Strunk and DeRubeis, 2001, Gloaguen et al., 1998).”
BackgroundTrials to assess equivalence: the importance of rigorous methods: Fig 1
Jones, B., Jarvis, P., Lewis, J. A., & Ebbutt, A. F. (1996) · BMJ · doi:10.1136/bmj.313.7048.36 · Cited by 1,032 · see citing works
Cognitive Therapy vs Medications in the Treatment of Moderate to Severe Depression
DeRubeis, R. J., Hollon, S. D., Amsterdam, J. D., Shelton, R. C., Young, P. R., Salomon, R. M., O’Reardon, J. P., Lovett, M. L., Gladis, M. M., Brown, L. L., et al. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.4.409 · Cited by 989 · see citing works
Self-citationJacobson, N. S., Roberts, L. J., Berns, S. B., & McGlinchey, J. B. (1999) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.67.3.300 · Cited by 853 · see citing works
Jacobson, N. S., Roberts, L. J., Berns, S. B., & McGlinchey, J. B. (1999) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.67.3.300 · Cited by 853 · see citing works
A meta-analysis of the effects of cognitive therapy in depressed patients
Gloaguen, V., Cottraux, J., Cucherat, M., & Blackburn, I.-M. (1998) · Journal of Affective Disorders · doi:10.1016/s0165-0327(97)00199-7 · Cited by 809 · see citing works
(2004) · Cited by 780 · see citing works
Cognitive Therapy and Pharmacotherapy for Depression: Singly and in Combination
Hollon, S. D. (1992) · Archives of General Psychiatry · doi:10.1001/archpsyc.1992.01820100018004 · Cited by 481 · cited 14× · see citing works
“-PA Author M anuscript N IH -PA Author M anuscript evidenced in RCTs, there was little evidence of superior outcomes in either setting.”
BackgroundMethodInfluentialThe effects of psychological therapies under clinically representative conditions: a meta-analysis
Shadish, W. R., Navarro, A. M., Matt, G. E., & Phillips, G. (2000) · Psychological Bulletin · doi:10.1037/0033-2909.126.4.512 · Cited by 381 · see citing works
Wade, W. A., Treat, T. A., & Stuart, G. L. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.66.2.231 · Cited by 292 · see citing works
Toward a more clinically valid approach to therapy research.
Goldfried, M. R., & Wolfe, B. E. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.66.1.143 · Cited by 273 · see citing works
Evidence that therapy works in clincally representative conditions.
Shadish, W. R., Matt, G. E., Navarro, A. M., Siegle, G., Crits-Christoph, P., Hazelrigg, M. D., Jorm, A. F., Lyons, L. C., Nietzel, M. T., Robinson, L., et al. (1997) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.65.3.355 · Cited by 186 · cited 1× · see citing works
“One area of concern with such evaluations, however, is the extent to which treatment in the “realworld” has been assessed under clinically representative conditions (Shadish et al., 1997; Shadish et al., 2000).”
BackgroundSelf-citationWestbrook, D., & Kirk, J. (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.09.006 · Cited by 183 · see citing works
A vision of the next generation of behavioral therapies research in the addictions*
Carroll, K. M., & Rounsaville, B. J. (2007) · Addiction · doi:10.1111/j.1360-0443.2007.01798.x · Cited by 177 · see citing works
Treatment of Atypical Depression With Cognitive Therapy or Phenelzine
Jarrett, R. B., SCHAFFER, M. H., McIntire, D. D., Witt-Browder, A., Kraft, D., & Risser, R. C. (1999) · Archives of General Psychiatry · doi:10.1001/archpsyc.56.5.431 · Cited by 174 · see citing works
Merrill, K. A., Tolbert, V., & Wade, W. A. (2003) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.71.2.404 · Cited by 163 · see citing works
Minami, T., Wampold, B. E., Serlin, R. C., Hamilton, E. G., Brown, G. S. (., & Kircher, J. C. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.1.116 · Cited by 120 · see citing works
Benchmarks for psychotherapy efficacy in adult major depression.
Minami, T., Wampold, B. E., Serlin, R. C., Kircher, J. C., & Brown, G. S. (. (2007) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.75.2.232 · Cited by 113 · see citing works
Persons, J. B., Bostrom, A., & Bertagnolli, A. (1999) · Cognitive Therapy and Research · doi:10.1023/a:1018724505659 · Cited by 111 · see citing works
Normative data for normative comparisons.
Kendall, P., & Sheldrick, R. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.5.767 · Cited by 100 · see citing works
Contribution of the therapeutic alliance to outcome in active versus control psychotherapies.
Carroll, K. M., Nich, C., & Rounsaville, B. J. (1997) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.65.3.510 · Cited by 95 · see citing works
Acceleration of changes in session impact during contrasting time-limited psychotherapies.
Reynolds, S. A., Stiles, W. B., Barkham, M., Shapiro, D. A., Hardy, G. E., & Rees, A. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.64.3.577 · Cited by 90 · see citing works
The Interpersonal, cognitive, and social nature of depression
(2006) · Choice Reviews Online · doi:10.5860/choice.44-1234 · Cited by 58 · see citing works
Cognitive therapy in the treatment and prevention of depression.
Hollon, S. D., DeRubeis, R. J., & Evans, M. D. (1996) · Cited by 54 · see citing works
Self-citationThe Interpersonal, Cognitive, and Social Nature of Depression
(2014) · Routledge eBooks · doi:10.4324/9780203941607 · Cited by 45 · see citing works
Cognitive Therapy for Depression: A Review of Its Efficacy
Strunk, D. R., & DeRubeis, R. J. (2001) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.15.4.289 · Cited by 43 · see citing works
Self-citationAn independent share in the work: Some thoughts on time-limited psychotherapy. a response to moss
Rubens, R. L. (1983) · New Ideas in Psychology · doi:10.1016/0732-118x(83)90013-2 · Cited by 4 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Whisman M Perez J Ramel W 2000 Factor structure of the Beck Depression Inventory-Second Edition (BDI-II) in a student sample J Clin Psychol 56 545 551 10775046
Cited by
Sorted by citations
Johnsen, T. J., & Friborg, O. (2015) · Psychological Bulletin · doi:10.1037/bul0000015 · Cited by 331 · see citing works
MARCHAND, W. R. (2012) · Journal of Psychiatric Practice® · doi:10.1097/01.pra.0000416014.53215.86 · Cited by 305 · see citing works
Hans, E., & Hiller, W. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0031080 · Cited by 211 · see citing works
Webb, C. A., Cohen, Z. D., Beard, C., Forgeard, M. J. C., Peckham, A., & Björgvinsson, Þ. (2019) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000451 · Cited by 96 · see citing works
Braun, J. D., Strunk, D. R., Sasso, K. E., & Cooper, A. A. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.05.004 · Cited by 91 · see citing works
Green, H., Barkham, M., Kellett, S., & Saxon, D. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.08.009 · Cited by 74 · see citing works
Saxon, D. H., Barkham, M., Foster, A., & Parry, G. D. (2016) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2028 · Cited by 72 · see citing works
von Brachel, R., Hirschfeld, G. H. F., Berner, A., Willutzki, U., Teismann, T., Cwik, J. C., Velten, J., Schulte, D., & Margraf, J. (2019) · Psychotherapy and Psychosomatics · doi:10.1159/000500188 · Cited by 49 · see citing works
Forand, N. R., Evans, S., Haglin, D., & Fishman, B. (2011) · Behavior Therapy · doi:10.1016/j.beth.2011.02.001 · Cited by 47 · see citing works
Lutz, W., Schiefele, A.-K., Wucherpfennig, F., Rubel, J. A., & Stulz, N. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.08.072 · Cited by 46 · see citing works
A Person-Centered Approach to Multicultural Counseling Competence
Quinn, A. E. (2012) · Journal of Humanistic Psychology · doi:10.1177/0022167812458452 · Cited by 48 · see citing works
Simmonds‐Buckley, M., Kellett, S., & Waller, G. (2019) · Behavior Therapy · doi:10.1016/j.beth.2019.01.003 · Cited by 41 · see citing works
Lopes, R. D. C. T., Gonçalves, M. M., Fassnacht, D. B., Machado, P. P. P., & Sousa, I. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.05.042 · Cited by 38 · see citing works
Rasing, S. P. A., Stikkelbroek, Y. A. J., & Bodden, D. H. M. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17010153 · Cited by 33 · see citing works
Peeters, F. P. M. L., Huibers, M. J. H., Roelofs, J., van Breukelen, G., Hollon, S. D., Markowitz, J. C., van Os, J., & Arntz, A. R. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.08.022 · Cited by 30 · see citing works
Schindler, A. C., Hiller, W., & Witthöft, M. (2011) · Psychotherapy Research · doi:10.1080/10503307.2011.602750 · Cited by 29 · see citing works
Luxton, D. D., Pruitt, L. D., O'Brien, K., Stanfill, K. E., Jenkins‐Guarnieri, M. A., Johnson, K. M., Wagner, A. W., Thomas, E. K., & Gahm, G. A. (2014) · Contemporary Clinical Trials · doi:10.1016/j.cct.2014.04.002 · Cited by 26 · see citing works
Therapist effects on dropout from a college counseling center practice research network.
Xiao, H., Castonguay, L. G., Janis, R. A., Youn, S. J., Hayes, J. A., & Locke, B. D. (2017) · Journal of Counseling Psychology · doi:10.1037/cou0000208 · Cited by 26 · see citing works
Bertrand, K., Brunelle, N., Richer, I., Beaudoin, I., Lemieux, A., & Ménard, J.-M. (2012) · Substance Use & Misuse · doi:10.3109/10826084.2012.733903 · Cited by 24 · see citing works
Metacognitive therapy in recurrent depression: A case replication series in Denmark
Callesen, P., Jensen, A. B., & Adrian Wells, A. (2013) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12089 · Cited by 25 · see citing works
Marchand, W. R. (2011) · Depression Research and Treatment · doi:10.1155/2012/246725 · Cited by 25 · see citing works
Stenberg, E., Cao, Y., Marsk, R., Sundbom, M., Jernberg, T., & Näslund, E. B. (2020) · PLoS Medicine · doi:10.1371/journal.pmed.1003307 · Cited by 20 · see citing works
Goldstein, L. A., Mandel, A. A., DeRubeis, R. J., & Strunk, D. R. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103608 · Cited by 19 · see citing works
Self-citationCognitive-behavioral treatment for depressed patients with Alzheimer’s disease. An open trial
García‐Alberca, J. M. (2017) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2017.02.008 · Cited by 19 · see citing works
Stenberg, E., Szabó, É., Ottosson, J., & Näslund, I. (2017) · British journal of surgery · doi:10.1002/bjs.10448 · Cited by 16 · see citing works
Gibbons, C. R., Wiltsey Stirman, S., DeRubeis, R. J., Newman, C. F., & Beck, A. T. (2013) · Cognitive Therapy and Research · doi:10.1007/s10608-012-9499-7 · Cited by 15 · see citing works
Self-citationScott, K., Klech, D., Lewis, C. C., & Simons, A. D. (2015) · Community Mental Health Journal · doi:10.1007/s10597-015-9876-2 · Cited by 14 · see citing works
Peipert, A., Rodríguez‐Quintana, N., & Lorenzo‐Luaces, L. (2022) · International Journal of Cognitive Therapy · doi:10.1007/s41811-022-00131-3 · Cited by 12 · see citing works
The efficacy of psychoeducation on recurrent depression: a randomized trial with a 2-year follow-up
Aagaard, J., Foldager, L., Makki, A., Hansen, V., & Müller-Nielsen, K. (2016) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2016.1266385 · Cited by 11 · see citing works
Simpson-Southward, C., Waller, G., & Hardy, G. (2018) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x18000089 · Cited by 6 · see citing works
Estupiñá, F. J., & Encinas, F. J. L. (2012) · The Spanish Journal of Psychology · doi:10.5209/rev_sjop.2012.v15.n3.39423 · Cited by 6 · see citing works
Harte, C. B., & Hawkins, R. C. (2016) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2016.210 · Cited by 5 · see citing works
Mindfulness for the Treatment of Depression
Marchand, W. R. (2015) · Springer eBooks · doi:10.1007/978-3-319-22255-4_7 · Cited by 4 · see citing works
Álvarez, E., Qutob, M., Mbuagbaw, L. C. E., Lavis, J. N., Lokker, C., Walli-Attaei, M., Samaan, Z., Sutton, A., Singh, J., Feeny, D. H., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-031298 · Cited by 3 · see citing works
Empirically Supported Treatments and Efficacy Trials: What Steps Do We Still Need to Take?
Nasser, J. D. (2013) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-013-9236-x · Cited by 2 · see citing works
Stress Management with Cardiac Patients
Lukens, C. L., Turkoglu, D., & Burg, M. M. (2012) · Springer eBooks · doi:10.1007/978-1-4419-5650-7_10 · Cited by 1 · see citing works
Terapia basada en Inteligencia Emocional: Un trabajo sistemático con emociones en psicoterapia
Lizeretti, N. P. (2017) · Revista de Psicoterapia · doi:10.33898/rdp.v28i107.175 · Cited by 1 · see citing works
Gahm, G. A., Luxton, D. D., Reger, M. A., Skopp, N. A., Bush, N. E., Wagner, A., Pruitt, L. D., Stanfill, K. E., & Jenkins‐Guarnieri, M. A. (2015) · doi:10.21236/ada623884 · Cited by 1 · see citing works
Whittington, A., & Grey, N. (2014) · doi:10.1002/9781394266487.ch1 · Cited by 1 · see citing works
Braun, J. D. (2011) · The Knowledge Bank (The Ohio State University)
Gahm, G. A., Luxton, D. D., Mishkind, M. C., Reger, M. A., Skopp, N. A., Bush, N. E., Wagner, A., Pruitt, L. D., & O'Brien, K. (2013) · doi:10.21236/ada580253
Autobiographical memory specificity and depression
Cheung, S.-L. (2010) · doi:10.5353/th_b4765698
Review of Humanity's dark side: Evil, destructive experience, and psychotherapy.
Quinn, A. E. (2013) · The Humanistic Psychologist · doi:10.1080/08873267.2013.771120
(2010) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/foc.8.1.foc48
Westas, M. (2022) · Linköping University Medical Dissertations · doi:10.3384/9789179293796
- Authors
- Gibbons, C. J., Fournier, J. C., Stirman, S. W., DeRubeis, R. J., Crits-Christoph, P., & Beck, A. T.
- Affiliations
- Yale University (US)
- University of Pennsylvania (US)
- Boston University (US)
- Corresponding author
- Gibbons, Carly J.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2010-09
- Volume
- 125
- Issue
- 1-3
- Pages
- 169-176
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC2888955
- OpenAlex
- W2059593063
- Cited by
- 46
- References
- 38
- Citations by year
- 2022: 2 · 2020: 2 · 2019: 6 · 2018: 1 · 2017: 4 · 2016: 3 · 2015: 6 · 2014: 4 · 2013: 5 · 2012: 7
- FWCI
- 7.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- U.S. Public Health Service (R49/CCR316866)
- National Institute of Mental Health (R10 MH55875, R00MH080100, R37MH047383, R10 MH50129, K02 MH01697, K02MH001697, MH47383, R10MH055875, K99MH080100, R10MH055877)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- cognitive therapy, depression, outpatient care, clinical effectiveness, routine clinical practice, intervention fidelity, symptom recovery, treatment protocol modification, symptom severity
- MeSH terms
- Adult, Ambulatory Care, Antidepressive Agents, Combined Modality Therapy, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Longitudinal Studies, Male, Middle Aged, Personality Inventory, Psychometrics, Reproducibility of Results, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
