Ready-Made, Recalibrated, or Remodeled? Issues in the Use of Risk Indexes for Assessing Mortality After Coronary Artery Bypass Graft Surgery

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Abstract

Background

Risk indexes for operative mortality after cardiac surgery are used for comparative profiling of surgeons or centers. We examined whether clinicians and managers should use an existing index without modification, recalibrate it for their populations, or derive a new model altogether.

Conclusions

Poorly calibrated risk algorithms can bias the calculation of RAOM and alter the results of surgeon-specific profiles. Any existing index used for risk assessment in cardiac surgery should be episodically recalibrated or compared with new models derived from local subjects to ensure that its performance remains optimal. (Circulation. 1999;99:2098-2104.)

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