Validation of a Measure of Physical Illness Burden at Autopsy: The Cumulative Illness Rating Scale

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Abstract
Objective: To further validate an objective measure of physical illness burden, the Cumulative Illness Rating Scale (CIRS). Design: Survey with correlation of CIRS ratings made from physician interviews and review of medical records with postmortem ratings made independently at tissue autopsy. Subjects: Victims of completed suicide investigated by both psychological and tissue autopsy (n = 72). Results: CIRS ratings made by examination of tissue at autopsy were highly predictive of analogous ratings based on historical data, accounting for 75% of the variance in CIRS scores. Taking autopsy findings as the gold standard of objective health assessment, historical ratings tend to underestimate physical illness at high levels of tissue pathology and to overestimate burden at lower levels. Conclusions: The CIRS score, when derived from all available sources of medical information, is a valid objective measure of physical illness burden and has broad applicability to research in geriatrics.