Medicine OPD Scoring System — pharmaadvance.in

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Medicine OPD Scoring System

pharmaadvance.in · 55+ Validated Clinical Tools

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Hepatology

5 tools

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Child-Pugh ScoreCirrhosis severity and surgical risk

⭐ StandardClass A/B/C

▾

Bilirubin (mg/dL)

Albumin (g/dL)

INR

Ascites

Encephalopathy

—/ 15

📋 Prescription-Ready

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MELD ScoreModel for End-stage Liver Disease

6–40Transplant

▾

Bilirubin (mg/dL)

INR

Creatinine (mg/dL)

Capped at 4.0; if dialysis use 4.0

Haemodialysis ≥2×/week?

—MELD

📋 Prescription-Ready

🧂

MELD-Na ScoreMELD incorporating sodium

Na-adjusted

▾

Bilirubin (mg/dL)

INR

Creatinine (mg/dL)

Serum Sodium (mEq/L)

Range used: 125–137 mEq/L

—MELD-Na

📋 Prescription-Ready

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FIB-4 IndexNon-invasive liver fibrosis screening

NAFLD/Viral

▾

Age (years)

AST (U/L)

ALT (U/L)

Platelets (×10⁹/L)

Formula: (Age × AST) ÷ (Platelets × √ALT)

—FIB-4

📋 Prescription-Ready

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APRI ScoreAST-to-Platelet Ratio Index — fibrosis

Cirrhosis

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AST (U/L)

AST upper limit of normal (U/L)

Platelets (×10⁹/L)

—APRI

📋 Prescription-Ready

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Nephrology

4 tools

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eGFR (MDRD Formula)Estimated GFR and CKD staging

⭐ StandardmL/min/1.73m²

▾

Serum Creatinine (mg/dL)

Age (years)

Sex

—mL/min/1.73m²

📋 Prescription-Ready

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Cockcroft-Gault CrClCreatinine clearance — drug dosing

Drug dosing

▾

Age (years)

Weight (kg)

Serum Creatinine (mg/dL)

Sex

—mL/min

📋 Prescription-Ready

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FENa — Fractional Excretion of SodiumPre-renal vs intrinsic AKI

AKI

▾

Serum Sodium (mEq/L)

Urine Sodium (mEq/L)

Serum Creatinine (mg/dL)

Urine Creatinine (mg/dL)

—%

📋 Prescription-Ready

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CKD Staging (KDIGO 2012)GFR + Albuminuria staging

G1–G5 / A1–A3

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eGFR (mL/min/1.73m²)

Urine ACR (mg/g)

—

📋 Prescription-Ready

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Diabetes & Endocrine

4 tools

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HbA1c InterpretationGlycated haemoglobin → average glucose

ADA 2024

▾

HbA1c (%)

Patient type

—mmol/mol

📋 Prescription-Ready

⚖️

BMI & Obesity ClassificationWHO + Asia-Pacific thresholds

kg/m²

▾

Weight (kg)

Height (cm)

Ethnicity

—kg/m²

📋 Prescription-Ready

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FINDRISCFinnish Diabetes Risk Score

0–26T2DM screening

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Age

BMI

Waist circumference

Not physically active (less than 30 min moderate/day)+2 Does NOT eat vegetables / fruit daily+1 Antihypertensive medication ever taken+2 High blood glucose found before (pregnancy / illness)+5 Family history of diabetes (first degree relative)+5

—/ 26

📋 Prescription-Ready

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HOMA-IRInsulin resistance assessment

Insulin resistance

▾

Fasting Glucose (mg/dL)

Fasting Insulin (µIU/mL)

—HOMA-IR

📋 Prescription-Ready

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Rheumatology

4 tools

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DAS28-CRPDisease Activity Score — RA

⭐ StandardRA

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Tender Joint Count (28 joints)

Swollen Joint Count (28 joints)

CRP (mg/L)

Patient Global Health (VAS 0–100 mm)

—DAS28

📋 Prescription-Ready

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DAS28-ESRDisease Activity Score with ESR

▾

Tender Joint Count (28)

Swollen Joint Count (28)

ESR (mm/hr)

Patient Global Health (VAS 0–100)

—DAS28

📋 Prescription-Ready

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CDAIClinical Disease Activity Index — no labs required

0–76No labs

▾

Tender Joint Count (28)

Swollen Joint Count (28)

Patient Global Assessment (0–10)

Evaluator Global Assessment (0–10)

—/ 76

📋 Prescription-Ready

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BASDAIAnkylosing Spondylitis Disease Activity

0–10AS/AxSpA

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Rate each 0 (none) to 10 (very severe) — last week:

1. Fatigue / tiredness

2. Axial pain (back/hips)

3. Peripheral joint pain/swelling

4. Tenderness to touch

5. Morning stiffness severity

6. Morning stiffness duration (0=none, 10=≥2h)

—/ 10

📋 Prescription-Ready

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Neurology

4 tools

♿

Modified Rankin Scale (mRS)Disability after stroke/neurological disease

⭐ Standard0–6

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0No symptoms

1No significant disability — able to carry out usual activities

2Slight disability — unable to carry out all previous activities, looks after self

3Moderate disability — requires some help, but able to walk unassisted

4Moderately severe — unable to walk and attend to bodily needs without help

5Severe disability — bedridden, incontinent, requires constant care

6Dead

—mRS

📋 Prescription-Ready

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ABCD² Score2-day stroke risk after TIA

TIA urgent0–7

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A — Age ≥60 years

B — BP ≥140/90 at presentation

C — Clinical features of TIA

D — Duration of symptoms

D₂ — Diabetes mellitus

—/ 7

📋 Prescription-Ready

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MIDASMigraine Disability Assessment Score

Migraine

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Days lost / productivity reduced ≥50% in past 3 months:

1. Days missed work / school

2. Days productivity reduced ≥50% at work/school

3. Days missed household work

4. Days productivity reduced ≥50% in housework

5. Days missed family/social/leisure activities

—MIDAS

📋 Prescription-Ready

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MMSE — Score Entry & InterpretationMini Mental State Examination

0–30Cognition

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MMSE Total Score (from administered test)

Patient education level

Administer the validated MMSE form; enter total score here for interpretation and prescription output.

—/ 30

📋 Prescription-Ready

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Palliative & Prognosis

2 tools

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ECOG Performance StatusFunctional status — treatment eligibility

⭐ Standard0–5

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0Fully active — no restrictions

1Restricted in strenuous activity but ambulatory; light work ok

2Ambulatory >50% waking hours; self-care only, no work

3Limited self-care; confined to bed/chair >50% waking hours

4Completely disabled; no self-care; totally confined to bed/chair

5Dead

—ECOG

📋 Prescription-Ready

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Karnofsky Performance Scale (KPS)Functional ability 0–100

0–100%Oncology

▾

100%Normal — no complaints, no disease

90%Able to carry on normal activity; minor signs/symptoms

80%Normal activity with effort; some signs/symptoms

70%Cares for self; unable to carry on normal work

60%Requires occasional assistance; cares for most needs

50%Requires considerable assistance and frequent medical care

40%Disabled — requires special care and assistance

30%Severely disabled — hospitalisation indicated

20%Very sick — active supportive treatment necessary

10%Moribund — fatal processes progressing rapidly

—%

📋 Prescription-Ready

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ADR & Pharmacovigilance

2 tools

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Naranjo ScaleADR causality assessment

⭐ Standard−4 to +13

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1. Previous conclusive reports on this reaction

2. ADR appeared after suspected drug given

3. ADR improved when drug discontinued

4. ADR reappeared on re-administration

5. Alternative causes can explain the ADR

6. ADR reappeared when placebo given

7. Drug detected in toxic concentration

8. Reaction more severe with higher dose

9. Patient had similar reaction before

10. ADR confirmed by objective evidence

—/ 13

📋 Prescription-Ready

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Modified Hartwig SeverityADR severity grading

Level 1–7

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Level 1Mild — no specific treatment required, no discontinuation

Level 2Moderate — requires change in drug therapy, no hospitalisation

Level 3Moderate — requires hospitalisation

Level 4Severe — life-threatening, requires intensive medical treatment

Level 5Severe — causes permanent damage

Level 6Severe — contributing cause of death

Level 7Fatal — directly responsible for patient death

—

📋 Prescription-Ready

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Psychiatry & Mood

3 tools

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PHQ-9Patient Health Questionnaire — depression severity

⭐ Standard0–27

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Over the last 2 weeks, how often have you been bothered by each? (0=Not at all · 1=Several days · 2=More than half days · 3=Nearly every day)

1. Little interest or pleasure in doing things

2. Feeling down, depressed, or hopeless

3. Trouble falling/staying asleep or sleeping too much

4. Feeling tired or having little energy

5. Poor appetite or overeating

6. Feeling bad about yourself / letting others down

7. Trouble concentrating on things

8. Moving/speaking slowly or being fidgety/restless

9. Thoughts that you would be better off dead or hurting yourself

—/ 27

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😰

GAD-7Generalised Anxiety Disorder scale

⭐ Standard0–21

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Over the last 2 weeks: (0=Not at all · 1=Several days · 2=More than half days · 3=Nearly every day)

1. Feeling nervous, anxious or on edge

2. Not able to stop or control worrying

3. Worrying too much about different things

4. Trouble relaxing

5. Being so restless it is hard to sit still

6. Becoming easily annoyed or irritable

7. Feeling afraid as if something awful might happen

—/ 21

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HAM-A (Hamilton Anxiety)Clinician-rated anxiety severity

0–56Clinician-rated

▾

Rate each item: 0=Absent · 1=Mild · 2=Moderate · 3=Severe · 4=Very severe

1. Anxious mood

2. Tension

3. Fears

4. Insomnia

5. Intellectual (cognitive difficulties)

6. Depressed mood

7. Somatic (muscular)

8. Somatic (sensory)

9. Cardiovascular symptoms

10. Respiratory symptoms

11. Gastrointestinal symptoms

12. Genitourinary symptoms

13. Autonomic symptoms

14. Behaviour at interview

—/ 56

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❤️

Cardiovascular — Extended

2 tools

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Wells PE ScorePre-test probability for Pulmonary Embolism

⭐ StandardPE

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Clinical signs/symptoms of DVT (leg swelling, pain on palpation of deep veins)+3 PE is #1 diagnosis OR equally likely+3 Heart rate >100 bpm+1.5 Immobilisation or surgery in previous 4 weeks+1.5 Previous DVT/PE+1.5 Haemoptysis+1 Malignancy (on treatment, treated in last 6 months, or palliative)+1

—points

📋 Prescription-Ready

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Framingham Risk Score (simplified)10-year CVD risk — primary prevention

10-yr riskPrimary prevention

▾

Age (years)

Sex

Total Cholesterol (mg/dL)

HDL Cholesterol (mg/dL)

Systolic BP (mmHg)

On antihypertensive treatment

Smoker (current)

Diabetes mellitus

—%

📋 Prescription-Ready

medopd

Medicine OPD Scoring System

Cardiovascular

Respiratory

Hepatology

Nephrology

Diabetes & Endocrine

Rheumatology

Neurology

Geriatric Medicine

Gastroenterology

Pain Assessment

Palliative & Prognosis

Infectious Disease

ADR & Pharmacovigilance

Psychiatry & Mood

Rheumatology — Extended

Cardiovascular — Extended