Validity of the score

The validity of a score is investigated to confirm that the score quantifies what it has been designed to measure ( Daley 1994). This can be approached in a number of ways: describing the distribution of the score, relating the score to other factors, relating the score to outcome, and comparing the score with other scores developed to measure the same entity. The following serve as examples.

It would be expected that patients would be admitted for intensive care across a wide range of severity as measured by the score, and that patients admitted for intensive care following elective surgery would show a narrower range of scores than patients admitted for intensive care following emergency surgery or as medical admissions.

A severity score would be expected to demonstrate a direct and consistent relationship with outcome, with increasing scores (representing increasing severity of illness) showing a strong association with increasing observed death before discharge from hospital following intensive care. A significant difference between mean severity scores for survivors and non-survivors would be expected.

Comparison of the score with independent clinical assessment of a patient and with other scores developed to measure the same entity should reveal consistent results. If one particular score is regarded as the gold standard, any new score should be tested against it.

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