title: The Complexity Signature: Developing a Tool to Communicate Biopsychosocial Severity of Disease for Children with Chronic Neurological Complexity.
abstract: Aim For children with medical complexity, interdisciplinary treatment approaches are required to address the various aspects defined within the biopsychosocial model. Methods The present study identifies dimensions of the biopsychosocial model to generate a standardized visualized severity score for chronic neurological diseases in children. We demonstrate the score's applicability and usefulness in clinical practice among clinicians with and without pediatric board certification with the aid of illustrative patient cases. The results are compared by Spearman correlation coefficient. Results Nine dimensions were identified as the basis for the development of the score, which consists of five grades of severity for each of the selected neuropediatric subsections. All board-certified pediatricians would recommend the application of the severity score in clinical routine. Furthermore, a good correlation was revealed between direct and indirect (severity score) assessment. Interpretation The severity score developed in this study takes into account biopsychosocial aspects of chronic diseases while being comprehensible and easily applicable in clinical routine-a biopsychosocial signature serving as an excellent, striking communication basis within the interdisciplinary team. However, upcoming studies including more patient cases are needed for further refinement.
authors.affiliation: Department of Neurosurgery, Klinikum rechts der Isar, TU München, Munich, Germany.
authors.forename: Sandro M
authors.initials: SM
authors.lastname: Krieg
authors.affiliation: Department of General and Abdominal Surgery, Community Hospital Munich Harlaching, Munich, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sonanini
authors.affiliation: Department of Neurosurgery, Klinikum rechts der Isar, TU München, Munich, Germany.
authors.forename: Nico
authors.initials: N
authors.lastname: Sollmann
authors.affiliation: Department of Health Management, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Focke
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, Integrated Social Pediatric Center, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Lucia
authors.initials: L
authors.lastname: Gerstl
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, Integrated Social Pediatric Center, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Heinen
mesh_terms: D001519:Behavior; D002547:Cerebral Palsy / Q000503:physiopathology / Q000523:psychology; D002648:Child; D003071:Cognition; D059026:Diagnostic Self Evaluation; D004827:Epilepsy / Q000503:physiopathology / Q000523:psychology; D006261:Headache / Q000503:physiopathology / Q000523:psychology; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000523:psychology; D009422:Nervous System Diseases / Q000503:physiopathology* / Q000523:psychology; D009468:Neuromuscular Diseases / Q000503:physiopathology / Q000523:psychology; D012720:Severity of Illness Index; D012931:Social Environment