THE DUKE SEVERITY OF ILLNESS CHECKLIST (DUSOI) FOR MEASUREMENT OF SEVERITY AND COMORBIDITY
THE DUKE SEVERITY OF ILLNESS CHECKLIST (DUSOI) FOR MEASUREMENT OF SEVERITY AND COMORBIDITY
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DOI：
10.1016/0895-4356(93)90153-r
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发表时间：
1993-04-01
影响因子：
7.2
通讯作者：
TSE, CKJ
中科院分区：
文献类型：
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作者：
PARKERSON, GR;BROADHEAD, WE;TSE, CKJ
杜克疾病严重程度检查表（DUSOI）进行了评估，414初级保健成人患者使用的数据收集的医疗服务提供者在病人访问时，后来由图表审计员。通过对四个非疾病特异性参数（症状水平、并发症、未经治疗的预后和对治疗的预期反应）的评分求和来确定个体诊断的严重程度评分。在21种最常见的诊断中，平均诊断严重程度评分（0 - 100分）从绝经综合征的13.9分到扭伤和拉伤的43.0分不等。通过合并诊断严重程度评分并给予最严重诊断最高权重来计算总体严重程度评分。提供者生成的总体严重性评分（平均值= 43.3）和供应商生成的总体严重性评分（平均值= 38.9）显著相关（一致性系数= 0.59，p <0.0001）。诊断在其对总体严重程度评分的个体贡献方面各不相同，从脂质紊乱的8.9%到扭伤和拉伤的90.0%。计算单独的合并症严重程度评分，以衡量除研究中的诊断外，每位患者所有健康问题的严重程度。例如，绝经综合征患者有并存的健康问题，其产生的平均合并症严重程度评分较高，为43.2，而扭伤和劳损患者的平均合并症评分较低，为4.7。DUSOI检查表可由提供者和稽查员在临床环境中使用，以产生完全基于临床判断的定量严重程度评分（按诊断、总体和合并症）。这种方法应该是有用的，在临床研究中控制疾病的严重程度，并指示医疗护理的结果，在医疗干预后的疾病严重程度的降低。
The Duke Severity of Illness Checklist (DUSOI) was evaluated on 414 primary care adult patients using data collected both by medical providers at the time of the patient visit and later by a chart auditor. Severity scores for individual diagnoses were determined by summing the ratings for four non-disease-specific parameters: symptom level, complications, prognosis without treatment, and expected response to treatment. Mean diagnosis severity scores (scale 0-100) among the 21 most prevalent diagnoses varied from a low of 13.9 for menopausal syndrome to a high of 43.0 for sprains and strains. An overall severity score was calculated by combining diagnosis severity scores and giving highest weights to the most severe diagnoses. Provider-generated overall severity scores (mean = 43.3) and auditor-generated overall severity scores (mean = 38.9) were significantly correlated (coefficient of agreement = 0.59, p < 0.0001). Diagnoses varied in their individual contribution to the overall severity score, from 8.9% for lipid disorder to 90.0% for sprains and strains. Separate comorbidity severity scores were calculated to measure the severity of all of each patient's health problems except the diagnosis under study. For example, patients with menopausal syndrome had co-existing health problems which generated a high mean comorbidity severity score of 43.2, while patients with sprains and strains had a low mean comorbidity score of 4.7. The DUSOI Checklist can be used in the clinical setting by both providers and auditors to produce quantitative severity scores (by diagnosis, overall, and for comorbidity) which are based entirely upon clinical judgment. This method should be useful in controlling for severity of illness in clinical studies and indicating the outcome of medical care in terms of reduction in severity of illness following medical interventions.