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Health Serv Res. 1979 Spring; 14(1): 56–67.
PMCID: PMC1072101

Indexes of severity: conceptual development.


A discussion of severity index development is presented in relation to conceptual issues in index definition, analytic issues in index formulation and validation issues in index application. The CHOP index is discussed along with six severity indexes described in an earlier paper dealing with underlying concepts to illustrate the material presented. Replies are provided to specific questions raised in an accompanying paper discussing the Injury Severity Score. This conceptual material is presented to provide a foundation for severity index development, to suggest criteria to be used in their formulation and testing, and to identify analyses that can lead to the successful selection and application of an index for a defined purpose.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Linn BS, Linn MW, Gurel L. Cumulative illness rating scale. J Am Geriatr Soc. 1968 May;16(5):622–626. [PubMed]
  • Baker SP, O'Neill B, Haddon W, Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974 Mar;14(3):187–196. [PubMed]
  • Kirkpatrick JR, Youmans RL. Trauma index. An aide in the evaluation of injury victims. J Trauma. 1971 Aug;11(8):711–714. [PubMed]
  • Williams RE, Schamadan JL. The 'SIMBOL' rating and evaluation system. A measurement tool for injured persons. Ariz Med. 1969 Nov;26(11):886–887. [PubMed]
  • Krischer JP. Indexes of severity: underlying concepts. Health Serv Res. 1976 Summer;11(2):143–157. [PMC free article] [PubMed]
  • Stoner HB, Barton RN, Little RA, Yates DW. Measuring the severity of injury. Br Med J. 1977 Nov 12;2(6097):1247–1249. [PMC free article] [PubMed]
  • Yates DW. Airway patency in fatal accidents. Br Med J. 1977 Nov 12;2(6097):1249–1251. [PMC free article] [PubMed]
  • Baker SP, O'Neill B. The injury severity score: an update. J Trauma. 1976 Nov;16(11):882–885. [PubMed]

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