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The Comorbidity Symptom Scale: a combined disease inventory and assessment of symptom severity
H L Crabtree1, C S Gray, A J Hildreth
1Department of Geriatric Medicine, University of Newcastle, Sunderland Royal Hospital, UK.
Objectives:
To develop and evaluate a scale to quantify the presence and severity of symptoms arising from comorbid diseases in older people.
Design:
A validation cohort study of hospital inpatients and outpatients aged 65 years and older.
Setting:
A Hospital and community in Northeast England.
Participants:
Development of the Comorbidity Symptom Scale-Convenience sample of 50 hospital inpatients and outpatients aged 65 years and older. Evaluation of the Comorbidity Symptom Scale- Convenience sample of 183 patients aged 65 years and older either awaiting cataract surgery or attending a geriatric day hospital.
Measurements:
For development of the Comorbidity Symptom Scale, 22 comorbid conditions were identified and incorporated into a questionnaire (the CmSS). Evaluation of the Comorbidity Symptom Scale-Assessments included the CmSS, activities of daily living, perceived health status, and anxiety and depression.
Results:
A 23-item scale was developed. Reliability of the CmSS was demonstrated by a test-retest correlation coefficient for the total instrument score of r = 0. 87 (P < .001). The CmSS scores correlated with assessments of activities of daily living, perceived health status, and anxiety and depression.
Conclusions:
The CmSS is a simple interviewer-administered tool for use in older people and provides an objective measure of the presence of comorbid disease and the patient's perception of severity of associated symptoms.