Critical care computing: outcomes, confidentiality, and appropriate use

This article reviews the current limitations of computerized outcome predictor models and severity scoring systems. A logical extension of predictor models, a "computational futility metric," is proposed with a discussion of potential uses and abuses. These types of electronic surveillance will not solve the problem of society's denial of death or resolve the allocation of medical resources. Issues related to the protection of patients and physicians under electronic epidemiologic surveillance are discussed.