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Clinical Utility Score of Kain

Purpose: To calculate a utility score for a drug regimen based on grading the different features of the drug(s) involved.

Description

For some diseases there are several possible therapeutic regimens, each of which may have different strengths and weaknesses. Kain used a "bottom line" clinical utility score to evaluate different drug regimens for the treatment of malaria. The author is from the University of Toronto.


The clinical utility score is based on identifying a variety of pertinent parameters in a drug regimen. Points are assigned for favorable or unfavorable features of each parameter. The clinical utility score is the sum of all the parameters. This can help guide physician and patient decision making.

 

Parameters for drug regimens may include:

(1) efficacy

(2) tolerability (absence of side effects)

(3) convenience

(4) causal activity

(5) cost

(6) contraindications for patient

 

Parameter

Finding

Points

efficacy

low

1

 

moderate

2

 

high

3

tolerability

fair to poor (occasional disabling side effects)

1

 

good (rare disabling side effects)

2

 

excellent (rare and minor side effects)

3

convenience

low

1

 

moderate

2

 

high

3

cost

expensive

1

 

moderate

2

 

inexpensive

3

contraindications for patient

significant

1

 

minor

2

 

none

3

 

where:

• I am not quite sure what causal activity is, so this will be left out of the implementation.

• The decision points are somewhat arbitrary and can be adjusted for the patient or situation.

• Convenience may involve the number of pills, the number of daily doses, the need to adjust diet, etc.

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 5

• maximum score: 15

• The higher the score, the more attractive the regimen.

• Since masking can occur (a series of high scores may compensate for a parameter with an unattractive feature) the number at each level should also be tallied.


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Specialty

Objective

ICD-10