Severity of illness scoring: one step closer to "the trenches".

Although not yet employed in routine clinical practice, severity of illness scoring has become an essential tool for health services research involving ill newborns(1,2), children(3), critically ill adults(4,5), and now even adults admitted to general medicalsurgical wards(6). One way to conceptualize these scores is that they provide us with a method to learn, within a short time, from the combined experience of tens of thousands of patient encounters, something no physician could hope to achieve in a lifetime of practice. In an era when electronic medical records are starting to become more widespread, it is conceivable that these scores will eventually become part of how all of us practice medicine. However, before these scores are transitioned from health services research papers into “the trenches,” considerable methodological work still needs to be performed.