Table 3.
Composite Symptom Severity Index Scoring Method For Bulk, Vaginal Bleeding, and Pelvic Pain
| Bulk Severity Index | |
|---|---|
| Points | Symptoms |
| 1 | Bloating (PT)†
Pelvic Pressure (PT) Uterine Size 50th-75th Percentile (LAB) |
| 2 | Bulk Diagnosis Code at Surgery (DX)‡ |
| 3 | Non-specified Bulk Symptoms (PT) Bulk as Indication for Surgery (MD)§ Bulk Diagnosis Code in Year Prior to Surgery (DX) |
| 4 | Uterine Size ≥ 75th Percentile (LAB) |
| Vaginal Bleeding Severity Index | |
| Points | Symptoms |
| 1 | Vaginal Bleeding Diagnosis Code at Surgery (DX) Heavy Bleeding (PT) Irregular Bleeding (PT) Heavy Bleeding as Indication for Surgery (MD) |
| 2 | Irregular Bleeding as Indication for Surgery (MD) Vaginal Bleeding Diagnosis Code in Year Prior to Surgery (DX) Period Last Longer than 7 Days (PT) Lethargia or Dizziness (PT) |
| 3 | Iron Use (MD) 1 ER Visit Related to Bleeding (DX) Anemia Diagnosis Code at Surgery (DX) |
| 4 | Anemia - HGB < 10 (LAB)¶ Anemia as Indication for Surgery (MD) More than 1 ER Visit Related to Bleeding (DX) 1 ER Visit Related to Anemia (DX) Anemia Diagnosis Code in Year Prior to Surgery (DX) |
| 5 | History of Blood Transfusion (MD) More than 1 ER Visit Related to Anemia (DX) |
| Pain Severity Index | |
| Points | Symptoms |
| 1 | Pelvic Pain (PT) Painful Periods (PT) Painful Intercourse (PT) Tylenol (PHARM)†† |
| 2 | NSAID (PHARM) Pain as Indication for Surgery (MD) Painful Periods as Indication for Surgery (MD) |
| 3 | Pain Diagnosis Code In Year Prior to Surgery (DX) Pain Diagnosis Code at Surgery (DX) Other Pain Medication (PHARM) |
| Points | Symptoms |
| 4 | Opioid (PHARM) At Least 1 Pain Related ER Visit (DX) Muscle Relaxant (PHARM) |
†
PT: Patient reported symptom as recorded in unstructured physician notes
‡
DX: Administrative billing code (ICD9, ICD10, CPT)
§
MD: Physician indicated reason for surgery in preoperative or operative notes
¶
LAB: Results from laboratory tests or pathology report
††
PHARM: Prescription information from pharmacy billing data