Classification of Severity of Health Problems in Family/general Practice: an International Field Trial

Background: A methodology is needed for classification of health problems by severity.

Objectives: We aimed to test the Duke Severity of Illness Checklist (DUSOI) for feasibility and usefulness.

Method: The DUSOI was field tested internationally by 22 family/general practitioners in 9 countries.

Results: The DUSOI was found to be feasible for rating severity of illness of health problems in family/general practice. The measure was shown to be clinically useful in older patients and those with chronic and more severe health problems. Variability of severity ratings was less within the same rater than between different raters (i.e. higher intrarater than interrater reliability). Clinical face validity was supported by the finding that DUSOI ratings classified patients with the same diagnosis and those with different diagnoses according to the severity differences that would be expected clinically.

Conclusions: Although research is needed to improve reliability and to test validity further, the DUSOI was shown in the present study to be a methodology that is reasonable for consideration as an international classification of health problems by their severity in primary care patients.