The Total Illness Burden Index
The Total Illness Burden Index is a comprehensive summary measure of case mix or severity of illness that aggregates all of the patients’ conditions, problems, and diseases, weighting them by their severity. The TIBI offers advantages over other methods
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Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
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Structure and Scoring of the TIBI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Constructing the Dimensions of the TIBI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Computing Raw Dimension Scores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 The Global Severity of Illness Measure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
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The Predictive Ability of the TIBI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
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Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Summary Points . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
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Springer Science+Business Media LLC 2010 (USA)
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The Total Illness Burden Index
Abstract: The Total Illness Burden Index is a comprehensive summary measure of case mix or > severity of illness that aggregates all of the patients’ conditions, problems, and diseases, weighting them by their severity. The TIBI offers advantages over other methods of case mix measurement because it (1) is based on clinical information beyond the simple presence or absence of specific diagnoses, (2) is scored using a psychometric approach that avoids reliance on any single variable, (3) predicts health related quality of life and mortality events five or more years in the future, (4) is feasible, utilizing patient report over administrative data while requiring less than 15 minutes to complete, and (5) can be adapted based on the clinical context to assess > comorbidity with respect to a selected index condition, or to assess total morbidity from all of the patient’s conditions. These features allow the measure to be applied in clinical settings among patients facing real-time treatment decisions and for risk adjustment in research on a wide range of medical outcomes. List of Abbreviations: ANOVA, analysis of variance; APACHE II, Acute Physiology and Chronic Health Evaluation II; CP, cardiopulmonary; HRQOL, health-related quality of life; SF-36, Medical Outcomes Study Short Form, a measure of health-related quality of life; TIBI, Total Illness Burden Index; TIBI-CaP, Prostate cancer version of the Total Illness Burden Index
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Introduction
The Total Illness Burden Index (Greenfield et al., 1995; Litwin; et al., 2007) is a comprehensive summary measure of severity of illness that aggregates all of the patients’ conditions, problems, and diseases, weighting them by their severity. The instrument is a reliable predictor of health-related quality of life
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