Severity scores in surgery: what for and who needs them? An introduction: definition, aims, classification and evaluation.
Every patient represents a unique and complex situation a clinician has to deal with. In order to cope with this complexity of information, reduction is necessary, especially in communication about diseases or therapy. The first reduction is made when a patient is given a diagnosis which reflects a constellation of similar symptoms. A score also reduces the given amount of clinical data into a one-dimensional value. The primary aim of a score is a systematic comparison between patients and institutions. Scores reduce information to focus on the essentials. They are used for severity classification and prognosis, evaluation of outcome and treatment effects, case-mix adjustments in comparative audits, and economic evaluation. Quality criteria of score systems which should be considered in the development and application are: reliability, validity, measurability, applicability, and clinical relevance. This introductory article gives a brief description of these terms.
Neugebauer
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Biochemical and Experimental Division, II. Department of Surgery, University of Cologne, Ostmerheimerstrasse 200, 51109 Cologne, Germany. sekretariat-neugebauer@uni-koeln.de
Lefering
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D013502:General Surgery / Q000145:classification / Q000592:standards*; D006801:Humans; D008485:Medical Audit; D017063:Outcome Assessment, Health Care; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D013514:Surgical Procedures, Operative / Q000145:classification