Development of Novel Poison Severity and Mortality Scale to Enhance Emergency Clinical Outcomes
Author(s)
Sannidhi Prabhu, PharmD1, Adusumilli Pramod Kumar, Ph.D2, Crispin Dona J, PharmD3.
1Student, M S Ramaiah University Of Applied Sciences, Bengaluru, India, 2M S Ramaiah University Of Applied Sciences, Bangalore, India, 3M S Ramaiah University Of Applied Sciences, Bengaluru, India.
1Student, M S Ramaiah University Of Applied Sciences, Bengaluru, India, 2M S Ramaiah University Of Applied Sciences, Bangalore, India, 3M S Ramaiah University Of Applied Sciences, Bengaluru, India.
OBJECTIVES: Poisoning remains a major medical emergency and public health concern, especially in low- and middle-income countries with limited healthcare access. Early severity assessment is vital to reduce mortality. This study aims to develop an accurate, practical scoring system for poisoning cases for timely treatment, guide clinical decisions, improve outcomes, and optimize healthcare resource use.
METHODS: An Ambispective study was conducted over a period of 7 months, 151 retrospective poisoning cases were collected to identify key parameters most relevant to clinical scenario. The novel scale was developed using a standardized process, which included steps such as domain determination, item development and formulation of scale. Suggestions of expert panels and statistical methods like descriptive statistics, Content Validity Ratio (CVR), Content Validity Index (CVI), Scale-CVI (S-CVI), modified Kappa coefficient and Intraclass Correlation Coefficient (ICC) were used to evaluate the validity and reliability of the improved scale.
RESULTS: A total of 151 retrospective poisoning cases were analysed (mean age: 29.46 years), mostly from urban areas, with pesticide poisoning being most common (36%). An initial 71-item scale (26 Mortality Domain, 45 Severity Domain) was reviewed by 25 experts from Emergency, Intensive Care Unit and General medicine department. Items with CVR <0.37 and CVI <0.78 were removed, retaining 37 items. The average S-CVI was 0.90 and the modified kappa for all items was found to be more than 0.80 depicting excellent reliability. Face validity showed unanimous expert agreement, and ICC was 0.894, indicating excellent consistency and reliability.
CONCLUSIONS: Poisoning remains a major public health concern, the improved scale has high excellent reliability and contributes meaningfully to the field of clinical toxicology by offering a more robust and adaptable tool for managing poisoning cases.
METHODS: An Ambispective study was conducted over a period of 7 months, 151 retrospective poisoning cases were collected to identify key parameters most relevant to clinical scenario. The novel scale was developed using a standardized process, which included steps such as domain determination, item development and formulation of scale. Suggestions of expert panels and statistical methods like descriptive statistics, Content Validity Ratio (CVR), Content Validity Index (CVI), Scale-CVI (S-CVI), modified Kappa coefficient and Intraclass Correlation Coefficient (ICC) were used to evaluate the validity and reliability of the improved scale.
RESULTS: A total of 151 retrospective poisoning cases were analysed (mean age: 29.46 years), mostly from urban areas, with pesticide poisoning being most common (36%). An initial 71-item scale (26 Mortality Domain, 45 Severity Domain) was reviewed by 25 experts from Emergency, Intensive Care Unit and General medicine department. Items with CVR <0.37 and CVI <0.78 were removed, retaining 37 items. The average S-CVI was 0.90 and the modified kappa for all items was found to be more than 0.80 depicting excellent reliability. Face validity showed unanimous expert agreement, and ICC was 0.894, indicating excellent consistency and reliability.
CONCLUSIONS: Poisoning remains a major public health concern, the improved scale has high excellent reliability and contributes meaningfully to the field of clinical toxicology by offering a more robust and adaptable tool for managing poisoning cases.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR61
Topic
Clinical Outcomes, Health Service Delivery & Process of Care, Patient-Centered Research
Topic Subcategory
Instrument Development, Validation, & Translation
Disease
Alternative Medicine, Mental Health (including addition), No Additional Disease & Conditions/Specialized Treatment Areas