TY - JOUR
T1 - Cardiac surgery risk models
T2 - A position article
AU - Shahian, David M.
AU - Blackstone, Eugene H.
AU - Edwards, Fred H.
AU - Grover, Frederick L.
AU - Grunkemeier, Gary L.
AU - Naftel, David C.
AU - Nashef, Samer A.M.
AU - Nugent, William C.
AU - Peterson, Eric D.
PY - 2004/11
Y1 - 2004/11
N2 - Differences in medical outcomes may result from disease severity, treatment effectiveness, or chance. Because most outcome studies are observational rather than randomized, risk adjustment is necessary to account for case mix. This has usually been accomplished through the use of standard logistic regression models, although Bayesian models, hierarchical linear models, and machine-learning techniques such as neural networks have also been used. Many factors are essential to insuring the accuracy and usefulness of such models, including selection of an appropriate clinical database, inclusion of critical core variables, precise definitions for predictor variables and endpoints, proper model development, validation, and audit. Risk models may be used to assess the impact of specific predictors on outcome, to aid in patient counseling and treatment selection, to profile provider quality, and to serve as the basis of continuous quality improvement activities.
AB - Differences in medical outcomes may result from disease severity, treatment effectiveness, or chance. Because most outcome studies are observational rather than randomized, risk adjustment is necessary to account for case mix. This has usually been accomplished through the use of standard logistic regression models, although Bayesian models, hierarchical linear models, and machine-learning techniques such as neural networks have also been used. Many factors are essential to insuring the accuracy and usefulness of such models, including selection of an appropriate clinical database, inclusion of critical core variables, precise definitions for predictor variables and endpoints, proper model development, validation, and audit. Risk models may be used to assess the impact of specific predictors on outcome, to aid in patient counseling and treatment selection, to profile provider quality, and to serve as the basis of continuous quality improvement activities.
UR - http://www.scopus.com/inward/record.url?scp=19644388834&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=19644388834&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2004.05.054
DO - 10.1016/j.athoracsur.2004.05.054
M3 - Article
C2 - 15511504
AN - SCOPUS:19644388834
SN - 0003-4975
VL - 78
SP - 1868
EP - 1877
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 5
ER -