Discriminative and predictive validity of risk assessment measures for women incarcerated for serious violent offences in Australia

Figures & data

Table 1. Time between when the assessments were conducted relative to release from prison.

Assessment	Days between assessment and release from prison^a			Days between release from prison and assessment^b
	n	M (SD)	Range	n	M (SD)	Range
LSI–R:SV	72	383.06 (339.78)	0–1337	4	232.5 (72.02)	161–296
LS/RNR	54	207.09 (236.63)	7–1106	24	119.17 (135.61)	9–514
HCR–20^V3	42	391.86 (253.99)	41–1110	12	310.83 (232.43)	43–664

Note: LSI–R:SV = Level of Service Inventory–Revised: Screening Version; LS/RNR = Level of Service/Risk, Need, Responsivity; HCR–20^V3 = Historical, Clinical, Risk Management 20–Version 3.

^aConducted in prison. ^bConducted in community.

Table 2. Descriptive statistics of the LSI–R:SV, LS/RNR and HCR–20^V3.

Measure	n	M	SD	Low	Medium	High
				n (%)	n (%)	n (%)
LSI–R:SV	76	5.80	1.62	3 (3.9)	22 (28.9)	51 (67.1)
LS/RNR Total	78	28.40	7.55	0 (0)	13 (16.7)	65 (83.3)
Criminal history	78	6.35	1.73	7 (9.0)	6 (7.7)	65 (83.3)
Education / employment	78	5.72	2.33	17 (21.8)	16 (20.5)	45 (57.7)
Family / marital	78	2.54	1.38	21 (26.9)	10 (12.8)	47 (60.3)
Leisure / recreation	78	1.63	0.65	7 (9.0)	15 (19.2)	56 (71.8)
Antisocial companions	78	3.33	0.96	5 (6.4)	12 (15.4)	61 (78.2)
Alcohol & drug problem	78	4.88	2.28	19 (24.4)	9 (11.5)	50 (64.1)
Procriminal attitude orientation	78	1.96	1.38	27 (34.6)	21 (26.9)	30 (38.5)
Antisocial pattern	78	1.99	1.22	27 (34.6)	20 (25.6)	31 (39.7)
HCR–20^V3 total	54/47^a	25.98	5.92	1 (1.9)	24 (44.4)	29 (53.7)
H-scale	65	15.90	2.61	–	–	–
C-scale	47	3.91	2.33	–	–	–
R-scale	47	6.05	2.74	–	–	–

Note: LSI–R:SV = Level of Service Inventory–Revised: Screening Version; LS/RNR = Level of Service/Risk, Need, Responsivity; HCR–20^V3 = Historical, Clinical, Risk Management 20–Version 3.

^an = 54 for structured professional judgement risk-level (low, moderate, high) data; n = 47 for total score item-level (M, SD) data.

Table 3. Recidivism outcomes by total sample and risk measure sub-sample.

	Sample
	Total (N = 79)	LSI–R:SV (n = 76)	LS/RNR (n = 78)	HCR–20^V (n = 54)
Rate of recidivism	n (%)	n (%)	n (%)	n (%)
Any recidivism	49 (62.0)	48 (63.2)	48 (61.5)	23 (42.6)
Violent recidivism	29 (36.7)	29 (38.2)	28 (35.9)	12 (22.2)
Non-violent recidivism	46 (58.2)	45 (59.2)	46 (59.0)	22 (40.7)
Time (days) at risk to recidivism		M (SD)	M (SD)	M (SD)
Any recidivism	—	221.75 (241.48)	187.08 (218.99)	207.43 (223.97)
Violent recidivism	—	241.21 (219.19)	215.46 (217.22)	204.00 (238.59)
Non-violent recidivism	—	222.84 (245.96)	190.87 (221.09)	218.05 (223.51)

Note: LSI–R:SV = Level of Service Inventory–Revised: Screening Version; LS/RNR = Level of Service/Risk, Need, Responsivity; HCR–20^V3 = Historical, Clinical, Risk Management 20–Version 3.

Figure 1. Survival curves in the LSI-R:SV sample, LS/RNR sample, and HCR-20^V3 sample depicting the probability of surviving (i.e., not recidivating) for any (top), violent (middle), and non-violent (bottom) recidivism according to risk classification.

Table 4. Recidivism Outcomes by Risk Level on the LSI–R:SV, LS/RNR and HCR–20^V3.

	Recidivism
	Any	Violent	Non-violent
	Risk level	n (%)	n (%)	n (%)
LSI–R:SV
Low	2 (66.7)	0 (0)	2 (66.7)
Medium	10 (45.5)	4 (18.2)	10 (45.5)
High	36 (70.6)	25 (49.0)	33 (64.7)
LS/RNR
Low	—	—	—
Medium	5 (38.5)	2 (15.4)	4 (30.8)
High	43 (66.2)	26 (40.0)	42 (64.6)
HCR–20^V3
Low	0 (0)	0 (0)	0 (0)
Moderate	9 (37.5)	4 (16.7)	8 (33.3)
High	14 (48.3)	8 (27.6)	14 (48.3)

Note: LSI–R:SV = Level of Service Inventory–Revised: Screening Version; LS/RNR = Level of Service/Risk, Need, Responsivity; HCR–20^V3 = Historical, Clinical, Risk Management 20–Version 3.

Table 5. Cox regression survival analysis and AUCs of the LSI–R:SV, LS/RNR, total scores and LS/RNR subscales for recidivism outcomes.

Sample	n	Recidivism
		Any	Violent	Non-violent
LSI–R:SV total score	76
HR [95% CI]		1.19 [0.98, 1.44]	1.44** [1.09, 1.90]	1.15 [0.95, 1.39]
C-Index^a		.55	.63	.53
AUC at 30 days		.65	.66	.55
AUC at 90 days		.56	.61	.55
AUC at 180 days		.52	.65	.52
AUC at 360 days		.64	.69	.61
AUC at 720 days		.77	.71	.75
IBS^a		.18	.20	.20
Brier skill score		0.33	0.24	0.23
LS/RNR total score	78
HR [95% CI]		1.05* [1.01, 1.10]	1.09** [1.03, 1.15]	1.06** [1.02, 1.11]
C-Index^a		.61	.67	.61
AUC at 30 days		.67	.71	.57
AUC at 90 days		.65	.73	.63
AUC at 180 days		.65	.75	.69
AUC at 360 days		.66	.77	.69
AUC at 720 days		.72	.72	.76
IBS^a		.18	.17	.18
Brier skill score		0.32	0.37	0.30
Criminogenic needs according to the LS/RNR
Criminal history	78
HR [95% CI]		1.32* [1.05, 1.66]	1.96** [1.29, 2.98]	1.31* [1.03, 1.68]
C-Index^a		.63	.68	.62
AUC at 30 days		.66	.71	.56
AUC at 90 days		.68	.67	.67
AUC at 180 days		.68	.71	.68
AUC at 360 days		.70	.77	.72
AUC at 720 days		.67	.76	.69
IBS^a		.18	.17	.19
Brier skill score		0.32	0.37	0.26
Education and employment	78
HR [95% CI]		1.10 [0.96, 1.25]	1.15 [0.97, 1.36]	1.13 [1.00, 1.29]
C-Index^a		.58	.58	.59
AUC at 30 days		.68	.65	.60
AUC at 90 days		.62	.60	.60
AUC at 180 days		.62	.63	.66
AUC at 360 days		.61	.60	.65
AUC at 720 days		.61	.60	.65
IBS^a		.19	.21	.20
Brier skill score		0.28	0.22	0.23
Family and marital	78
HR [95% CI]		1.08 [0.87, 1.33]	1.42* [1.04, 1.94]	1.11 [0.89, 1.39]
C-Index^a		.55	.63	.55
AUC at 30 days		.61	.62	.51
AUC at 90 days		.59	.71	.57
AUC at 180 days		.59	.69	.60
AUC at 360 days		.57	.67	.59
AUC at 720 days		.65	.70	.67
IBS^a		.19	.20	.20
Brier skill score		0.28	0.26	0.23
Leisure and recreation	78
HR [95% CI]		1.51 [0.92, 2.50]	2.02 [0.98, 4.17]	1.53 [0.91, 2.57]
C-Index^a		.58	.61	.59
AUC at 30 days		.66	.65	.65
AUC at 90 days		.66	.68	.66
AUC at 180 days		.64	.66	.66
AUC at 360 days		.61	.65	.60
AUC at 720 days		.55	.55	.54
IBS^a		.18	.20	.20
Brier skill score		0.32	0.26	0.23
Antisocial companions	78
HR [95% CI]		0.91 [0.69, 1.21]	1.11 [0.75, 1.63]	0.95 [0.71, 1.28]
C-Index^a		.52	.52	.50
AUC at 30 days		.43	.39	.38
AUC at 90 days		.50	.52	.49
AUC at 180 days		.52	.55	.54
AUC at 360 days		.58	.63	.60
AUC at 720 days		.43	.50	.46
IBS^a		.19	.21	.20
Brier skill score		0.28	0.22	0.23
Alcohol and drug problem	78
HR [95% CI]		1. 16* [1.01, 1.32]	1.21* [1.00, 1.46]	1.18* [1.03, 1.35]
C-Index^a		.58	.63	.59
AUC at 30 days		.62	.59	.64
AUC at 90 days		.61	.62	.62
AUC at 180 days		.61	.65	.63
AUC at 360 days		.58	.68	.59
AUC at 720 days		.70	.63	.69
IBS^a		.19	.20	.19
Brier skill score		0.28	0.26	0.26
Procriminal attitude orientation
HR [95% CI]	78	1.12 [0.90, 1.38]	1.24 [0.95, 1.64]	1.16 [0.93, 1.44]
C-Index^a		.54	.59	.54
AUC at 30 days		.59	.70	.48
AUC at 90 days		.56	.66	.54
AUC at 180 days		.56	.63	.57
AUC at 360 days		.56	.65	.59
AUC at 720 days		.73	.66	.76
IBS^a		.18	.19	.19
Brier skill score		0.32	0.30	0.26
Antisocial pattern
HR [95% CI]	78	1.15 [0.91, 1.46]	1.41* [1.03, 1.93]	1.22 [0.95, 1.55]
C-Index^a		.55	.62	.55
AUC at 30 days		.60	.65	.51
AUC at 90 days		.56	.65	.54
AUC at 180 days		.58	.69	.59
AUC at 360 days		.57	.70	.61
AUC at 720 days		.68	.69	.71
IBS^a		.18	.19	.18
Brier skill score		0.32	0.30	0.30

Note: LSI–R:SV = Level of Service Inventory–Revised: Screening Version; LS/RNR = Level of Service/Risk, Need, Responsivity; AUC = area under the curve; HR = hazard ratio; CI = confidence interval; IBS = integrated Brier score.

^aBootstrapping validation (with 300 bootstrapped datasets) indicated that bootstrap C-Index and bootstrap IBS values were within 0.03 and 0.05 of reported C-Index and reported IBS values, respectively.

*p < .05. **p < .01.

Table 6. Cox regression survival analysis and AUCs of the HCR–20^V3 total score and H-Scale score for all recidivism outcomes.

Sample	n	Recidivism
		Any	Violent	Non-violent
HCR–20^V3 total score	54
HR [95% CI]		0.99 [0.91–1.08]	1.01 [0.91–1.14]	1.01 [0.93–1.10]
C-Index^a		.49	.57	.53
AUC at 30 days		.56	.56	.59
AUC at 90 days		.45	.53	.45
AUC at 180 days		.43	.50	.49
AUC at 360 days		.47	.57	.49
AUC at 720 days		.32	.48	.33
IBS^a		.20	.18	.20
Brier skill score		0.22	0.45	0.23
Post hoc analyses
HCR–20^V3 H-Scale	65
HR [95% CI]		1.05 [0.92–1.19]	1.26* [1.02–1.56]	1.04 [0.90–1.19]
C-Index^a		.57	.65	.56
AUC at 30 days		.63	.77	.58
AUC at 90 days		.62	.83	.62
AUC at 180 days		.58	.63	.59
AUC at 360 days		.57	.63	.56
AUC at 720 days		.48	.64	.48
IBS^a		.22	.18	.22
Brier skill score		0.12	0.40	0.12

Note: HCR–20^V3 = Historical, Clinical, Risk Management 20–Version 3. AUC = area under the curve; HR = hazard ratio; CI = confidence interval; IBS = integrated Brier score.

^aBootstrapping validation (with 300 bootstrapped datasets) indicated that bootstrap C-Index and bootstrap IBS values were within 0.06 and 0.05 of reported C-Index and reported IBS values, respectively.

*p < .05.

Table 7. Sensitivity, specificity, positive predictive value and negative predictive value metrics for the measures at different cut-offs at 360 days at risk.

Cut-off	Recidivism
	Any				Violent				Non-violent
	Sens.	Spec.	PPV	NPV	Sens.	Spec.	PPV	NPV	Sens.	Spec.	PPV	NPV
LSI–R:SV^a
≤5	74.82	44.00	64.56	56.16	82.57	43.24	43.01	82.70	72.68	40.74	58.05	56.92
LS/RNR^a
≤19	92.29	23.08	61.34	69.36	95.18	19.51	33.10	90.64	94.59	22.22	58.85	77.73
≤29	57.22	73.08	73.76	56.36	76.44	73.17	54.38	88.13	60.80	74.07	73.39	61.64
HCR–20^V3
Mod: High	62.27	50.00	48.16	63.98	76.21	51.85	26.75	90.43	66.31	50.00	47.87	68.18
≤29	31.37	70.59	43.31	58.94	40.88	78.26	28.04	86.47	34.20	70.59	42.94	62.38
H-Scale
16^b	60.60	65.22	63.66	62.21	68.63	58.82	33.07	86.35	61.52	62.50	58.76	65.16

Note: LSI–R:SV = Level of Service Inventory–Revised: Screening Version; LS/RNR = Level of Service/Risk, Need, Responsivity; HCR–20^V3 = Historical, Clinical, Risk Management 20–Version 3. Sens. = sensitivity; Spec. = specificity; PPV = positive predictive value; NPV = negative predictive value; Mod = moderate.

^aCut-off scores corresponding to low risk are not included due to few/no women assessed as low risk. ^bA cut-off score of 16 or below was used to explore test statistics for the H-Scale, reflecting the sample mean.