TY - JOUR T1 - Clinical scores in primary care JF - British Journal of General Practice JO - Br J Gen Pract SP - 163 LP - 163 DO - 10.3399/bjgp20X708941 VL - 70 IS - 693 AU - Hajira Dambha-Miller AU - Hazel Everitt AU - Paul Little Y1 - 2020/04/01 UR - http://bjgp.org/content/70/693/163.abstract N2 - Clinical scoring systems are algorithms designed to predict outcomes, aid decision making, support treatment options, manage clinical risk, or improve efficiency. The term clinical scoring system is known interchangeably as clinical decision rule, prediction algorithm, clinical prediction tool, risk score, or scoring tool.1 Medicine is not short of these, with recent searches estimating that over 250 000 are available to use.2 Despite the proliferation of algorithms to inform clinical care, this has not been matched with evidence of their utility. The uncertainty among clinicians about their efficiency and accuracy, alongside growing primary care workloads in the limited 10-minute consultation, may contribute to low utility. As demonstrated in the accompanying systematic review by Willis et al,3 there is the additional complication of multiple scores being available for the same condition. So how do we decide on whether to use a clinical score and what makes one better than another?The first consideration is whether a score is needed or can be shown to provide clinical benefit. Scores should reduce uncertainty, prompt missed diagnoses, increase efficiency, and improve outcomes. If a score is not adding to clinical judgment, productivity, or improving outcomes then it becomes a laborious tick-box exercise. It also needs to be relevant to the clinical context in which it is applied. Despite thousands of scores having been developed, less than a handful of these are designed specifically for the UK primary care context. This is highlighted by the Centor and McIsaac criteria that are examined in the accompanying review. … ER -