O risco dos escores de risco e o sonho pelo BraSCORE

Age, Creatinine and Ejection Fraction Score in Brazil: Comparison with InsCor and the EuroSCORE

“…These instruments are usually evaluated in terms of accuracy (discriminative power), calibration and clinical performance. Many authors have emphasized that the level of precision rarely exceeds an area under the ROC curve of 0.75 (value that is inappropriate for clinical purposes), and that calibration may be inaccurate for low and high risk groups 16 . Risk scores are developed through statistical methods and subsequently validated in other populations to assess its clinical applicability.…”

EuroSCORE II and the importance of a local model, InsCor and the future SP-SCORE

“…The inclusion of many variables increases the risk of errors that can be caused by differences in interpretation of definitions, types, or conflicting information. The reduced number of variables without affecting its accuracy ("few variables as possible") in comprehensive models is one of the most important aspects of the cost, popularity and applicability of risk scores [ 12 , 24 ] .…”

“…In the modern evolution of risk assessment, it has been widespread the concept of applying external models and remold them to the characteristics of the region [ 25 ] . To apply a risk score, it must first be remolded (adaptation of the variables and their weights) or at least recalibrated (adjusting the weights of the variables) and never used form of ready-made (without adaptation of the variables and their weights) [ 24 ] . In Brazil, the adhesion of a model itself is of paramount importance, especially by differences in patient characteristics, clinical presentation due to socioeconomic, cultural and geographical reasons, the uneven distribution of medical facilities and the high endemicity of subclinical inflammation, infection and rheumatic disease [ 25 ] .…”

Implementation of Multicenter Records in the Therapeutic Cardiovascular Assessment in Brazil

“…Finally, the constitution of the SP-SCORE-SUS registry to evaluate the results of cardiac surgeries in the State of São Paulo, based on previous publications of a national reference center 11,12 , fills an important gap with respect to the employment and results of cardiovascular surgical therapy, expected to be expanded at a national level 13 .…”