BACKGROUND: As part of conducting a randomized control trial (RCT) to treat chronically high utilizing patients with medically unexplained symptoms (MUS), we developed the chart rating method reported here to identify and classify MUS subjects. METHOD: Intended at this point only as a research tool, the method is comprehensive, uses explicit guidelines, and requires clinician raters. It distinguishes primary organic disease patients from those with primary MUS, quantifies medical comorbidities in primary MUS patients, and also distinguishes subgroups among MUS patients that we call somatization (resembles DSM-IV somatoform disorders) and minor acute illness (MAI) which differs from DSM-IV somatoform definitions. Scoring rules are used to generate the diagnoses above. The rules may be set according to the investigator's needs, from highly sensitive to highly specific. RESULTS: We found high levels of agreement with the gold standard for MUS vs. organic disease (97.6%) and among raters for the key individual chart elements rated (92-96%). The method identified 206 MUS subjects and the extent of their medical comorbidities for entry into a RCT. It also identified somatization and MAI; the latter supports the validity of this newly reported MAI syndrome. CONCLUSION: We concluded that this method offered research potential for identifying MUS patients, for quantifying their medical comorbidities, and for classifying MUS subgroups. Copyright 2004 S. Karger AG, Basel
RCT Entities:
BACKGROUND: As part of conducting a randomized control trial (RCT) to treat chronically high utilizing patients with medically unexplained symptoms (MUS), we developed the chart rating method reported here to identify and classify MUS subjects. METHOD: Intended at this point only as a research tool, the method is comprehensive, uses explicit guidelines, and requires clinician raters. It distinguishes primary organic diseasepatients from those with primary MUS, quantifies medical comorbidities in primary MUS patients, and also distinguishes subgroups among MUS patients that we call somatization (resembles DSM-IV somatoform disorders) and minor acute illness (MAI) which differs from DSM-IV somatoform definitions. Scoring rules are used to generate the diagnoses above. The rules may be set according to the investigator's needs, from highly sensitive to highly specific. RESULTS: We found high levels of agreement with the gold standard for MUS vs. organic disease (97.6%) and among raters for the key individual chart elements rated (92-96%). The method identified 206 MUS subjects and the extent of their medical comorbidities for entry into a RCT. It also identified somatization and MAI; the latter supports the validity of this newly reported MAI syndrome. CONCLUSION: We concluded that this method offered research potential for identifying MUS patients, for quantifying their medical comorbidities, and for classifying MUS subgroups. Copyright 2004 S. Karger AG, Basel
Authors: D Mischoulon; R McColl-Vuolo; S Howarth; I T Lagomasino; J E Alpert; A A Nierenberg; M Fava Journal: Psychother Psychosom Date: 2001 Mar-Apr Impact factor: 17.659
Authors: Robert C Smith; Judith S Lyles; Joseph C Gardiner; Corina Sirbu; Annemarie Hodges; Clare Collins; Francesca C Dwamena; Catherine Lein; C William Given; Barbara Given; John Goddeeris Journal: J Gen Intern Med Date: 2006-07 Impact factor: 5.128
Authors: Robert C Smith; Joseph C Gardiner; Judith S Lyles; Corina Sirbu; Francesca C Dwamena; Annemarie Hodges; Clare Collins; Catherine Lein; C William Given; Barbara Given; John Goddeeris Journal: Psychosom Med Date: 2005 Jan-Feb Impact factor: 4.312
Authors: Robert C Smith; Joseph C Gardiner; Zhehui Luo; Susan Schooley; Lois Lamerato; Kathryn Rost Journal: J Gen Intern Med Date: 2009-04-30 Impact factor: 5.128