Medical Tools

Rapid bedside tool to identify patients outside ICU at risk of sepsis-related poor outcomes.

Singer M et al. JAMA 2016

Stratifies severity of community-acquired pneumonia. Score ≥3 warrants HDU/ICU consideration.

Lim WS et al. Thorax 2003

Risk stratification for chest pain presentations in the ED. Guides disposition and MACE risk at 6 weeks.

Backus BE et al. Crit Pathways Cardiol 2010

Predicts 14-day risk of death, new MI, or urgent revascularisation in UA/NSTEMI.

Antman EM et al. JAMA 2000

Estimates 1-year major bleeding risk in patients on anticoagulation for AF. Does not contraindicate anticoagulation.

Pisters R et al. Chest 2010

Pre-operative cardiac risk assessment. Recommended by ACC/AHA guidelines for non-cardiac surgery.

Lee TH et al. Circulation 1999

Average perfusion pressure throughout the cardiac cycle. Target ≥ 65 mmHg in septic shock.

Formula: DBP + ⅓(SBP − DBP)

Rate-corrected QT interval. Prolonged QTc (> 440 ms men, > 460 ms women) increases Torsades risk.

Bazett HC. Heart 1920

Estimates annual stroke risk in non-valvular atrial fibrillation to guide anticoagulation decisions.

Gage BF et al. JAMA 2001

Classifies heart failure severity by functional limitation to guide treatment and estimate prognosis.

Criteria Committee NYHA 1994

Stratifies heart failure severity following acute myocardial infarction to predict 30-day mortality.

Killip T, Kimball JT. Am J Cardiol 1967

Estimates 6-month mortality after ACS. Guides management intensity, discharge timing, and need for early invasive strategy.

Fox KA et al. Lancet 2006

Rules out PE without further testing when ALL 8 criteria are absent and pre-test probability is low (<15%). Sensitivity >97%.

Kline JA et al. J Thromb Haemost 2004

Stratifies PE pre-test probability using fully objective variables — no physician gestalt required. Alternative to Wells PE score.

Le Gal G et al. Ann Intern Med 2006

Classifies IE likelihood using major and minor clinical, microbiological, and echocardiographic criteria. Guides diagnostic workup and treatment decisions.

Li JS et al. Clin Infect Dis 2000 (Modified Duke Criteria)

Predicts major in-hospital bleeding risk in NSTEMI/UA. Guides anticoagulation intensity and early invasive strategy timing.

Subherwal S et al. Circulation 2009

Predicts 30-day mortality in STEMI to guide reperfusion strategy and risk-stratification for early intervention.

Morrow DA et al. Circulation 2000

Guides decision to extend DAPT beyond 12 months after PCI by balancing ischaemic benefit against bleeding risk. Score ≥2 favours prolonged DAPT.

Yeh RW et al. JAMA 2016

Key indicator of oxygenation failure severity. Berlin definition: mild ARDS < 300, moderate < 200, severe < 100.

ARDS Definition Task Force. JAMA 2012

Differentiates causes of hypoxaemia. Elevated gradient suggests V/Q mismatch, shunt or diffusion defect.

Normal upper limit ≈ (Age + 10) / 4 mmHg

Predicts all-cause and respiratory mortality in COPD. Superior to FEV1 alone as a prognostic marker.

Celli BR et al. NEJM 2004

Screens for moderate-severe obstructive sleep apnoea using 8 clinical variables. Score ≥3 warrants further evaluation; ≥5 has high sensitivity for severe OSA.

Chung F et al. Anesthesiology 2008

Stratifies CAP severity. Classes I-II: outpatient; Class III: short admission or observation; Classes IV-V: inpatient/ICU.

Fine MJ et al. N Engl J Med 1997

Predicts need for intensive respiratory or vasopressor support (IRVS) in community-acquired pneumonia to identify ICU candidates early.

Charles PG et al. Clin Infect Dis 2008

Stratifies risk of in-hospital mortality and need for mechanical ventilation in acute COPD exacerbation.

Shorr AF et al. Chest 2011

Predicts 2-day stroke risk following TIA. Score ≥ 4 warrants same-day specialist assessment.

Johnston SC et al. Lancet 2007

Predicts 30-day mortality after intracerebral haemorrhage. Score 0 = 0% mortality, score 5 = 100%.

Hemphill JC et al. Stroke 2001

Grades the clinical severity of subarachnoid haemorrhage to predict surgical risk and outcome.

Hunt WE, Hess RM. J Neurosurg 1968

Assesses level of sedation or agitation in critically ill patients, particularly those on mechanical ventilation.

Sessler CN et al. Am J Respir Crit Care Med 2002

Measures functional disability after stroke. Standard outcome measure in stroke trials. Score 0–2 = independent outcome; ≥3 = dependent.

van Swieten JC et al. Stroke 1988

Classifies SAH extent on CT to predict risk of symptomatic cerebral vasospasm. Grade 3 carries highest vasospasm risk.

Fisher CM et al. Neurosurgery 1980

Estimates CrCl for drug dosing. Standard formula for renal dose adjustment (not for CKD staging).

Cockcroft DW, Gault MH. Nephron 1976

Detects unmeasured anions in metabolic acidosis. Corrected for hypoalbuminaemia. Normal: 3–11 mEq/L.

Feldman M et al. J Am Soc Nephrol 2005

Differentiates pre-renal from intrinsic renal AKI. FENa < 1% = pre-renal. Invalid on diuretics — use FEUrea instead.

Miller TR et al. Ann Intern Med 1978

Estimates glomerular filtration rate from creatinine, age, and sex for CKD staging and monitoring.

Levey AS et al. Ann Intern Med 1999

Differentiates pre-renal from intrinsic renal AKI, particularly useful when diuretics preclude interpretation of FENa.

Carvounis CP et al. Kidney Int 2002

Calculates the free water deficit in hypernatraemia to guide fluid replacement and safe correction rate.

Adrogue HJ, Madias NE. NEJM 2000

Corrects measured serum sodium for the dilutional effect of hyperglycaemia to reveal true osmolar status.

Katz MA. N Engl J Med 1973

Body weight relative to height. WHO classification for adults. Does not account for muscle mass.

WHO Technical Report Series 894. 2000

Adjusts total calcium for hypoalbuminaemia. Total calcium is falsely low when albumin is low.

Payne RB et al. BMJ 1973

Difference between measured and calculated osmolality. Gap > 10 mOsm/kg suggests toxic alcohols, ketones, or renal failure.

UK formula: 2[Na] + [glucose] + [urea] (all in mmol/L)

Calculates ideal and adjusted body weight for drug dosing, particularly in obese patients where actual weight overestimates volume of distribution.

Devine BJ. Drug Intell Clin Pharm 1974

Calculates the bicarbonate deficit in metabolic acidosis to guide sodium bicarbonate replacement dose.

Standard clinical formula

Screens for depression severity using 9 DSM-based symptom questions over the past 2 weeks.

Kroenke K et al. J Gen Intern Med 2001

Screens for and measures severity of generalised anxiety disorder using 7 symptom questions over the past 2 weeks.

Spitzer RL et al. Arch Intern Med 2006

Brief 3-item screen for hazardous or harmful alcohol consumption derived from the full AUDIT tool.

Bush K et al. Arch Intern Med 1998

Four-question screening tool for identifying possible alcohol dependence or problem drinking.

Ewing JA. JAMA 1984

Self-rated daytime sleepiness scale using 8 common situations to screen for excessive somnolence.

Johns MW. Sleep 1991

Stratifies severity of liver cirrhosis and estimates 1-year survival using five clinical and laboratory parameters.

Pugh RN et al. Br J Surg 1973

Predicts 90-day mortality in patients with end-stage liver disease and guides organ allocation priority.

Kamath PS et al. Hepatology 2001

Post-endoscopy risk stratification for rebleeding and mortality after acute upper gastrointestinal haemorrhage.

Rockall TA et al. Gut 1996

Pre-endoscopy triage tool for upper GI bleeding to identify patients requiring urgent inpatient intervention.

Blatchford O et al. Lancet 2000

Predicts severity and mortality of acute pancreatitis using 5 admission criteria and 6 criteria assessed at 48 hours.

Ranson JH et al. Surg Gynecol Obstet 1974

Simplified Crohn's Disease Activity Index (CDAI) requiring no 7-day diary. 5 clinical variables. Score ≥5 = active disease.

Harvey RF, Bradshaw JM. Lancet 1980

Assesses UC disease activity without endoscopy. Guides treatment decisions including escalation to biologics or surgery.

Schroeder KW et al. N Engl J Med 1987

Predicts 28-day survival in alcoholic hepatitis. Score ≥9 indicates poor prognosis and supports corticosteroid therapy.

Forrest EH et al. Gut 2005

Assessed at day 7 of corticosteroid therapy. Score ≥0.45 identifies non-responders in whom steroids should be stopped.

Louvet A et al. Hepatology 2007

Estimates the pre-test probability of DVT to guide further investigation.

Wells PS et al. Lancet 1997

Stratifies pre-test probability of pulmonary embolism to guide imaging decisions.

Wells PS et al. Ann Intern Med 2001

Quantifies VTE risk in surgical patients to guide pharmacological and mechanical prophylaxis.

Caprini JA. Semin Thromb Hemost 2010

Identifies medical inpatients at high risk of VTE who require thromboprophylaxis.

Barbar S et al. J Thromb Haemost 2010

Assesses cervical favourability before induction of labour to predict success.

Bishop EH. Obstet Gynecol 1964

Screens for postnatal (and antenatal) depression; identifies women requiring clinical review.

Cox JL et al. Br J Psychiatry 1987

Evaluates neonatal wellbeing immediately after birth to guide resuscitation decisions.

Apgar V. Curr Res Anesth Analg 1953

Calculates the expected date of delivery (EDD) from the last menstrual period (LMP) using Naegele's Rule.

Naegele FC. 1812

Quantifies croup severity across five clinical parameters to guide triage and treatment decisions.

Westley CR et al. Am J Dis Child 1978

Detects early clinical deterioration in hospitalised children across behaviour, cardiovascular, and respiratory domains.

Monaghan A. Paediatr Nurs 2005

Estimates probability of Group A streptococcal pharyngitis to guide antibiotic prescribing and swab testing.

McIsaac WJ et al. CMAJ 1998

Predicts probability of septic arthritis in children to differentiate from transient synovitis of the hip.

Kocher MS et al. J Bone Joint Surg Am 1999

Classifies a patient's pre-anaesthetic medical comorbidities to stratify perioperative risk.

Doyle DJ et al. StatPearls 2024

Screens hospitalised patients for nutritional risk to identify those who benefit from nutritional support.

Kondrup J et al. Clin Nutr 2003

Identifies adults who are malnourished, at risk of malnutrition, or obese to guide clinical intervention.

BAPEN/MUST 2003

Assesses pressure ulcer risk across six subscales; lower scores indicate higher risk.

Braden B, Bergstrom N. Nurs Res 1987

Comprehensive pressure ulcer risk tool incorporating build, skin type, age, continence, mobility, and special risk factors.

Waterlow J. Nurs Times 1985

Classifies a cancer patient's functional status to guide treatment intensity and clinical trial eligibility.

Oken MM et al. Am J Clin Oncol 1982

Quantifies cancer patient's functional impairment to compare effectiveness of therapies and assess prognosis.

Karnofsky DA, Burchenal JH. 1949

Predicts 10-year mortality based on a weighted score of 17 comorbid conditions, widely used in oncology and surgery.

Charlson ME et al. J Chronic Dis 1987

Combines tumour size, lymph node stage, and histological grade to estimate prognosis in early breast cancer.

Galea MH et al. Breast Cancer Res Treat 1992

Quantifies lower urinary tract symptom severity in men with benign prostatic hyperplasia or prostate cancer.

Barry MJ et al. J Urol 1992

Rapidly assesses trauma severity using GCS, systolic blood pressure, and respiratory rate to triage and predict survival.

Champion HR et al. J Trauma 1989

Calculates Lactated Ringer's fluid requirements for the first 24 hours following a significant burn injury.

Baxter CR, Shires T. Ann NY Acad Sci 1968

Quantifies RA disease activity using 28 joint counts and CRP. Guides treatment escalation and biological therapy decisions. Remission defined as DAS28-CRP <2.6.

Wells G et al. J Rheumatol 2009; Prevoo ML et al. Arthritis Rheum 1995

Measures SLE disease activity across 24 weighted descriptors. Guides treatment intensity and monitors flares. Score >4 indicates active disease.

Gladman D et al. J Rheumatol 2002

Patient-reported AS disease activity index. Score ≥4 indicates active disease and supports consideration of biological therapy.

Garrett S et al. J Rheumatol 1994

Classifies gout in patients with ≥1 episode of peripheral joint/bursa swelling, pain, or tenderness. Requires ≥8 points to classify as gout (sensitivity 92%, specificity 89%).

Neogi T et al. Ann Rheum Dis 2015

Screens for undiagnosed type 2 diabetes and impaired fasting glucose using 8 questions. Score ≥15 warrants HbA1c/fasting glucose testing.

Lindström J, Tuomilehto J. Diabetes Care 2003

Estimates insulin resistance from fasting glucose and insulin. HOMA-IR >2.5 suggests significant insulin resistance; used in metabolic syndrome assessment.

Matthews DR et al. Diabetologia 1985

Classifies DKA as mild, moderate, or severe based on pH, bicarbonate, and mental status to guide ICU vs ward management.

ADA Standards of Medical Care. Diabetes Care 2009; JBDS DKA Guidelines 2013

Risk stratifies thyroid nodules on ultrasound to guide biopsy and follow-up. TR4 and TR5 have progressively higher malignancy risk.

Tessler FN et al. Radiology 2017

Rapid 10-question bedside cognitive screen. Score ≤7 suggests cognitive impairment requiring further evaluation. Takes ~2 minutes to administer.

Hodkinson HM. Age Ageing 1972

Identifies hospitalised patients at risk of falling. Score ≥45 indicates high risk requiring active fall prevention interventions.

Morse JM et al. Int J Nurs Stud 1987

Multidomain frailty assessment for pre-operative and medical patients. Score ≥8 indicates frailty requiring targeted interventions.

Rolfson DB et al. Age Ageing 2006

Rapid 6-item nutritional screening for older adults. Score <12 indicates risk of malnutrition requiring full MNA and dietitian assessment.

Rubenstein LZ et al. J Gerontol 2001

Measures functional independence across 10 ADL domains. Used in rehabilitation to track recovery and guide discharge planning. Score 100 = fully independent.

Mahoney FI, Barthel DW. Maryland State Med J 1965

Clinical decision rule for ankle/foot X-ray after acute injury. >98% sensitive for clinically important fractures. Reduces unnecessary imaging by ~30%.

Stiell IG et al. JAMA 1994

Decision rule for knee X-ray after acute injury. >98% sensitivity for clinically important fractures. Validated to safely reduce imaging by 25–50%.

Stiell IG et al. Ann Emerg Med 1996

Determines need for cervical spine imaging after trauma in alert, stable adults (GCS 15). More specific than NEXUS criteria. Validated to reduce unnecessary C-spine imaging by 42%.

Stiell IG et al. JAMA 2001

Predicts prognosis in diffuse large B-cell lymphoma (DLBCL). 5 risk factors scored 0-5.

NEJM 1993

Revised IPSS stratifies MDS prognosis. Based on cytogenetics, blasts, haemoglobin, platelets, ANC.

Greenberg et al, Blood 2012

Calculates ANC from WBC and differential. ANC < 500 = severe neutropenia; risk of serious infection.

Standard formula

Predicts 30-day mortality in bacteraemic patients. Score ≥4 associated with high mortality.

Paterson DL et al. Medicine 2004; Al-Hasan MN et al. CID 2013

IDSA/ATS 2007 minor criteria for severe CAP requiring ICU admission. ≥3 criteria = severe.

IDSA/ATS 2007

Quantifies psoriasis severity and area. Score 0-72. PASI 75/90 are endpoints for biologic trials.

Fredriksson & Pettersson, Dermatologica 1978

Scores atopic dermatitis severity. Combines extent, intensity, and subjective symptoms. Max 103.

European Task Force on Atopic Dermatitis, Dermatology 1993

Calculates BSA using Mosteller formula. Used for chemotherapy dosing, cardiac index, and fluid management.

Mosteller, NEJM 1987

Calculates Basal Metabolic Rate (BMR). Used for nutritional prescribing and caloric target estimation in hospitalised patients.

Revised Harris-Benedict, Roza & Shizgal 1984