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. Author manuscript; available in PMC: 2020 Apr 14.
Published in final edited form as: J Pain Symptom Manage. 2019 Aug 9;58(5):844–850.e2. doi: 10.1016/j.jpainsymman.2019.08.003

Appendix Table 2.

Validity and Feasibility Ratings of Serious Illness Definitions After Two Rounds of Expert Advisory Panel Rating

Serial Number Definition Median Score for Validitya Median Score for Feasibilityb
1. ASA Risk: Class IV or V 8.5 6.5
2. Vulnerable elder 8   8  
 • Older adult >84 years old
 • Older adult >64 with any functional or cognitive disability
3. Advanced cancer 8   7.5
 • Stage III and IV solid cancers OR hematologic malignancies
 • AND at least one hospitalization in prior year
4. Oxygen-dependent pulmonary disease 8   8  
5. Heart failure diagnosis with any all-cause hospitalization or at least two ED visits in past six months 8   7  
6. Cirrhosis with any Child-Turcotte-Pugh (CTP) Class or Model for End-Stage Liver Disease (MELD) score 8   7.5
7. End-stage renal disease on dialysis or eligible for dialysis 9   9  
8. Dementia with impaired daily function and at least one hospitalization in prior year 8   7  
9. Frailty 7.5 7  
10. Trauma patients 8   9  
 • Severe traumatic brain injury with Abbreviated Injury Scale score of 3 or greater
 • Critical injury (Injury Severity Score >25 or >24 hours intensive care unit admission)
11. Nursing home resident 8   8.5

ASA = American Society of Anesthesiology; ED = emergency department.

a

Validity was defined as adequate scientific evidence or professional consensus exists to support that a) this definition describes serious illness in the context of patients considering surgery and b) this definition could be applied to surgical patients. Validity was scored on a scale of 1–9, where 1 was definitely not valid and 9 was definitely valid.

b

Feasibility was defined as whether hospitals and/or surgeons within a range of practice settings (private or public, academic or nonacademic, urban or rural) could identify a patient with the definition given reasonable effort. Feasibility was scored on a scale of 1–9, where 1 was definitely not feasible and 9 was definitely feasible.