Assessing the Relationship between Performance onthe University of California Performance Skills Assessment(UPSA) and Outcomes in Schizophrenia: A Systematic Reviewand Evidence Synthesis

To perform a systematic review of the published literature to evaluate how functional capacity, as measured by theUniversity of California at San Diego (UCSD) Performance-based Skills Assessment (UPSA), relates to other functional measuresand real-world outcomes among individuals with schizophrenia.Methods.TheMEDLINEand Embasedatabases were searchedto identify joint evaluations with UPSA and key functional outcomes (functional scale measures; generic or disease-specific, health-related quality of life [HRQoL]; or real-world outcomes [residential status; employment status]) in patients with schizophrenia.Pearson correlations were estimated between UPSA scores, HRQoL, other functional scale measures, and real-world outcomes, foroutcomes described in at least six studies.Results. The synthesis included 76 studies that provided 73 unique data sets. Quantitativeassessment between the Specific Level of Function (SLOF) (n=18) scores and UPSA scores demonstrated a moderate borderline-significant correlation (0.45,p=0.06). Quantitative analysis of the relationship between the Global Assessment of Functioning(GAF) (n=11) and the Multidimensional Scale of Independent Functioning (MSIF) (n=6) scales revealed moderate and smallnonsignificant Pearson correlations of -0.34 (p=0.31) and 0.12 (p=0.83), respectively. There was a small borderline-significantcorrelation between UPSA score and residential status (n=36; 0.31;p=0.08), while no correlation was found between UPSA scoreand employment status (n=19; 0.04;p=0.88).Conclusion.TheSLOFwasthemostoftenusedfunctionalmeasureandhadthestrongest observed correlation with the UPSA. Although knowledge gaps remain, evidence from this review indicates that there isa quantitative relationship between functional capacity and real-world outcomes in individuals with schizophrenia.