THEORETICAL AND PRACTICAL LIMITATIONS OF SCORING SYSTEMS

Trauma-scoring is a measurement of injury severity. Before conclusions can be drawn from their results, their validity, reliability and prac ticability need to be known. With respect to these factors the followi ng statements may be proposed: some scores do have relatively low inte r-rater reliability; retrospective interpretation of findings and diag noses in the patient records may be equivocal; parameters contributing to the score may be lacking in some records; scoring may be time-cons uming; the parameters selected to make up the score may not include al l the relevant ones; the influence of time is neglected; different met hods of patient selection may confound the interpretation of scoring r esults; most scores are only evaluated with respect to mortality; the scores are interpreted exclusively on the basis of statistical probabi lities. We suggest that such scores as the ISS, PTS, (R) TS, which hav e been fairly well studied with respect to validity, reliability, and practicability, be prepared.