VALIDATION OF A MEASURE OF PHYSICAL ILLNESS BURDEN AT AUTOPSY - THE CUMULATIVE ILLNESS RATING-SCALE

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 under-estimate 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.