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Risk calculators-methods, development, implementation, and validation.

Ulrich Mansmann1, Anna Rieger2, Brigitte Strahwald2,3

  • 1Department of Medical Information Sciences, Biometry, and Epidemiology (IBE), Ludwig Maximilians Universität (LMU), München, Marchioninistraße 15, 81377, München, Germany. mansmann@ibe.med.uni-muenchen.de.

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Summary
This summary is machine-generated.

Surgical risk calculators (SRCs) predict patient outcomes using historical data. Implementing these tools requires addressing technical challenges and clinician training for effective shared decision-making.

Keywords:
ASC NSQIPShared decision makingSurgical risk calculator

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Area of Science:

  • Medical Informatics
  • Surgical Outcomes Research
  • Health Services Research

Background:

  • Surgical Risk Calculators (SRCs) estimate probabilities of adverse events like complications or death.
  • Risk estimates are derived from patient data and statistical models based on large patient cohorts.
  • SRCs aid in assessing surgical patient risk for informed decision-making.

Purpose of the Study:

  • To discuss the development and clinical implementation of Surgical Risk Calculators (SRCs).
  • To explore the statistical modeling, validation, and software aspects of SRCs.
  • To examine the role of SRCs in shared decision-making and quality of care evaluation.

Main Methods:

  • Development of statistical risk models for SRCs.
  • Validation and software implementation of SRCs.
  • Evaluation of SRC impact on patient outcomes and institutional quality.

Main Results:

  • The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) SRC is a prominent example.
  • A comparable initiative exists in Germany via the German Society for Visceral and General Surgery (DGAV).
  • Transportability of SRCs across different healthcare systems (e.g., US to Germany) presents challenges.

Conclusions:

  • SRCs are vital for enhancing shared decision-making between patients and surgeons.
  • Successful clinical implementation necessitates overcoming technical hurdles and providing adequate clinician training.
  • Specific study designs are crucial for evaluating the clinical impact of SRCs.