Cumulative Illness Rating Scale was a reliable and valid index in a family practice context

Abstract 

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-MD/I ranged from 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.

Keywords: Cumulative Illness Rating Scale, Comorbidity, Multimorbidity, Primary care, Family practice, Validation studies