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Scoring systems for medical illness (Ideal scoring system (1 - Scores…
Scoring systems for medical illness
Purpose
Stratify groups of critically ill patients by severity
Compare groups of patients in research trials
Predict mortality for individuals and groups
Most measure physiological variables and are derived from large data sets
Ideal scoring system
1 - Scores calculated on basis of easily/routinely recordable variables
2 - Well calibrated
3 - High level of discrimination
4 - Applicable to all patient populations in ICU
5 - Can be used in different countries
6 - The ability to predict mortality, functional status or quality of life after ICU discharge
Examples
APACHE - Acute physiology, age and chronic health evaluation
GCS - E4M6V5
SOFA (sequential organ failure assessment)
Advantages
Providing common language for discussion
Provision of risk-adjusted expected mortality rates facilitating comparisons for clinical trials
Estimates of prognosis
Providing a method by which critical care practice and processes can be examined
Disadvantages
Limited value for individual patient
Poor prognostic performance
Poor calibration for different health systems
Requires adherence by large numbers of users
Changing baselines of populations and interventiuons