Severity scoring systems and the practice of evidence-based medicine in the intensive care unit

Scoring systems to measure the severity of illness in patients in the intensive care unit have evolved significantly over the past decade and are gaining widespread acceptance among health care providers and institutions. Evidence-based medicine has also established a firm foothold in critical care as a new paradigm that enables individuals and institutions to find and appraise the current best evidence in the care of patients. These trends intersect in an intriguingly symbiotic relationship. Evidence-based health care provides the methods to assess the validity and utility of scoring systems, and scoring systems are one important tool in a key component of the critical appraisal exercise–comparing populations in clinical studies. This review outlines the development of intensive care unit scoring systems and evidence-based medicine and then highlights recent articles that well define their interaction.