title: Cumulative Illness Rating Scale was a reliable and valid index in a family practice context.
abstract: OBJECTIVE
  The goal of this study was to validate an instrument measuring the clinical burden of several medical problems in the same patient (multimorbidity), in a family practice context and, more specifically, to verify if trained nurses can score the Cumulative Illness Rating Scale (CIRS) from chart review.
  
  
  METHODS
  A convenience sample of 40 patients was selected. The attending physicians scored the CIRS during clinical interview (CIRS-MD/I), then three nurses scored the CIRS during clinical interview (CIRS-NUR/I) and three other nurses scored the CIRS from chart review (CIRS-NUR/C) (interrater reliability). Two of these nurses scored the CIRS-NUR/C again 2 months later (intrarater reliability).
  
  
  RESULTS
  For interrater reliability, the intraclass correlation coefficients were 0.81 (0.70-0.89) for the CIRS-NUR/I and 0.78 (0.66-0.87) for the CIRS-NUR/C. The intrarater reliability of the CIRS-NUR/C was 0.89 (0.80-0.94) for one of the nurses and 0.80 (0.65-0.89) for the other. Concomitant validity of these two forms of CIRS with the CIRS-MD/I ranged from 0.73 to 0.84.
  
  
  CONCLUSIONS
  The CIRS appears to be a reliable and valid instrument in a primary care context and trained nurses can score the CIRS from chart review.
authors.affiliation: Department of Family Medicine, Sherbrooke University, Quebec, Canada. catherine.hudon@ssss.gouv.qc.ca
authors.forename: C
authors.initials: C
authors.lastname: Hudon
authors.forename: M
authors.initials: M
authors.lastname: Fortin
authors.forename: A
authors.initials: A
authors.lastname: Vanasse
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015897:Comorbidity; D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009740:Nursing Staff; D011320:Primary Health Care / Q000379:methods; D011792:Quebec; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D016037:Single-Blind Method