Journal
JOURNAL OF CLINICAL EPIDEMIOLOGY
Volume 58, Issue 6, Pages 603-608Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jclinepi.2004.10.017
Keywords
Cumulative Illness Rating Scale; comorbidity; multimorbidity; primary care; family practice; validation studies
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Background and 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. Study Design and Setting: 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-NID/I ranged frorn 0.73 to 0.84. Conclusion: 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. (c) 2005 Elsevier Inc. All rights reserved.
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