As with most questionnaires in psychiatry, there is no established standard of care for the use of the Kennedy Axis V or the Kennedy NOSIE. You must use reasonable clinical judgment in making clinical decisions related to the Kennedy Axis V and Kennedy NOSIE. The book, MASTERING THE KENNEDY AXIS V (c) 2003, will provide guidelines for the use of the Kennedy Axis V and the Kennedy NOSIE; however, you are responsible for clinical decisions you make in association with your use of the Kennedy Axis V and/or the Kennedy NOSIE.

Both the Kennedy Axis V and the Kennedy NOSIE are excellent clinical instruments; however, their accuracy may vary widely depending on a number of factors, including the following:

* The level of training the raters have in the use of the instruments
* The clinical skills of the raters
* The time available to do the clinical assessments and ratings
* The accuracy of the information provided to the raters
* The ability of the raters to translate their clinical impressions and/or observations into the ratings
* The raters' frequency of using the instruments
* Idiosyncratic factors that may make rating particular patients very difficult
* Inaccuracies that are inherent in almost any instrument that measures something as complicated and elusive as human symptoms and behaviors
* Clinical and administrative pressures to give patients particular scores to justify various clinical and administrative decisions

You must be able to defend clinical decisions that you make in conjunction with the use of the Kennedy Axis V and/or the Kennedy NOSIE. You must stand behind your decisions based on your overall clinical assessment of the accuracy of the information gained from using these instruments in your clinical practice. Included in your clinical assessment should be your familiarity with the Kenendy Axis V and/or the Kennedy NOSIE and your assessment of the skills and accuracy of the persons who are making the ratings. If you are unsure of the accuracy of the ratings, you should proceed much more cautiously, including being much more aggressive about gathering additional information to support any clinical decisions that you are making.

As with many other instruments measuring human symptoms and behaviors, you are strongly discouraged from mechanically making clinical decisions solely on the basis of the scores generated by the Kennedy Axis V or the Kennedy NOSIE.