Predictive Ability of an Illness Severity Measure: Implications for Nursing Research

Abstract

Background and PurposeIllness severity among children with life-limiting illnesses is measured with the pediatric complex chronic conditions (CCC) measure. Developed in 2000/2001, it was revised in 2014 to include infant-specific categories.MethodsDiscrimination, calibration, accuracy, and validation tests were used to examine the predictive performance of the measures.ResultsAmong the 10,175 infants in the analysis, both measures poorly discriminated—palliative care consultation (C-statistics 0.6396 vs. C-statistics 0.5905) and any inpatient procedure (C-statistics 0.6101 vs. C-statistics 0.5160). The Hosmer–Lemeshow goodness-of-fit tests revealed good calibration for both measures. The original measure was more accurate in predicting end-of-life outcomes—palliative care consultation (Brier Score 0.3892 vs. 0.7787) and any inpatient procedures (Brier Score 0.3115 vs. 0.4738).ConclusionsThe revised measure did not perform any better than the original in predicting end-of-life outcomes among infants.