Clinical grading and the effects of scaling

Abstract

In clinical practice, there has been a need to grade the magnitude or the severity of the functions and qualities that are assessed in the examination. It is popular to use a four-step grading scale to categorize the severity of clinical findings. The authors discuss clinical grading scales and their influence on the clinician's ability to detect change. These principles have been applied to grades or measures derived from either objective measuring instruments, subjective tests, or techniques in which the clinician makes subjective judgments. A hypothetical data set was used to show the problems associated with using grading scales that are too coarse. The authors presented a mathematic mod..