Prachand et al proposed a scoring system for Medically Necessary, Time-Sensitive (MeNTS) procedures that would aid decision making when manage scarce resources or increased risk. This consists of 3 subscores - procedure, disease and patient. The authors are from the University of Chicago.
Parameters:
(1) effectiveness of a nonoperative treatment option
(2) risk of nonoperative treatment option
(3) impact of 2-week delay on disease outcome
(4) impact of 2-week delay on surgical difficulty or risk
(5) impact of 6-week delay on disease outcome
(6) impact of 6-week delay on surgical difficulty or risk
Parameter
Finding
Points
effectiveness nonoperative rx
none available
1
< 40% as effective as surgery
2
40 to 60% of surgical effectiveness
3
61 to 95% of surgical effectiveness
4
equally effective
5
risk of nonoperative rx
significantly worse or not applicable
1
somewhat worse
2
equivalent
3
somewhat better
4
significantly better
5
impact of 2-week delay on disease outcome
significantly worse
1
much worse
2
moderately worse
3
slightly worse
4
no worse
5
impact of 2-week delay on surgical difficulty/risk
significantly worse
1
much worse
2
moderately worse
3
slightly worse
4
no worse
5
impact of 6-week delay on disease outcome
significantly worse
1
much worse
2
moderately worse
3
slightly worse
4
no worse
5
impact of 6-week delay on surgical difficulty/risk
significantly worse
1
much worse
2
moderately worse
3
slightly worse
4
no worse
5
subscore =
= SUM(points for all of the parameters)
Interpretation:
• minimum subscore: 6
• maximums subscore: 30
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