Can the American College of Surgeons Risk Calculator Predict 30-Day Complications After Knee and Hip Arthroplasty?

Edelstein, Adam I.; Kwasny, Mary; Suleiman, Linda I.; Khakhkhar, Rishi H.; Moore, Michael A.; Beal, Matthew D.; Manning, David W.

doi:10.1016/j.arth.2015.01.057

Cited by 110 publications

(70 citation statements)

References 26 publications

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“…The results of our study are perhaps unsurprising as it is ambitious to expect a single tool to be able to accurately predict complications for a diverse range of surgical procedures. Our findings support previous reports demonstrating lack of validity of the universal risk calculator in both arthroplasty and pulmonary surgery . Many of the parameters collected in the calculator pertain to acutely ill patients and may be less relevant to elective surgery.…”

Section: Discussionsupporting

confidence: 88%

Can the ACS-NSQIP surgical risk calculator predict post-operative complications in patients undergoing flap reconstruction following soft tissue sarcoma resection?

et al. 2016

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Section: Discussionsupporting

confidence: 88%

Can the ACS-NSQIP surgical risk calculator predict post-operative complications in patients undergoing flap reconstruction following soft tissue sarcoma resection?

et al. 2016

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“…A study evaluating the ACS-NSQIP surgical risk calculator in TJA patients found that the tool failed to accurately predict individual patient complications; in this regard, it was not useful as a tool for patient communication regarding preoperative risks. An arthroplasty-specific risk calculator is needed [10].…”

Section: Quality/risk Stratificationmentioning

confidence: 99%

Pay-for-performance in orthopedics: how we got here and where we are going

Goldman

Kates

2017

Curr Rev Musculoskelet Med

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Purpose of the review Recent health laws have shifted from the traditional fee-for-service model toward a pay-forperformance model. In this changing climate, it is imperative that a provider understands these changes and recognizes the importance of health services research on medicine. Recent findings Increasing the value of care by improving quality and decreasing cost has been the focus of several projects. Preventing complications may be an effective way to increase value. Summary Patient risk stratification is a modifiable variable that will allow for improved patient selection. This in turn may reduce adverse events, thereby lessening the economic burden of complications, increased length of stay, and hospital readmission. Providers must partner with their hospitals to align their goals and maximize quality and efficiency in order to decrease costs.

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“…For example, the American College of Surgeons National Surgical Quality Improvement Program surgical risk calculator 4 is reported to have generally good accuracy across a very wide range of procedures and specialties. However, other researchers 5,6 have found that this tool has low accuracy when tested for specific patients and procedures that differ from the overall sample in terms of the prevalence of inputs and outcomes.…”

Section: Is the Model Accurate For Subgroups?mentioning

confidence: 98%

Three Critical Questions That Should Be Asked Before Using Prediction Models for Clinical Decision Support

Harris

2019

JAMA Netw Open

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To paraphrase Yogi Berra and perhaps others, 1 prediction is hard, especially about the future. Chaudhary and colleagues 2 therefore should be commended for producing a moderately accurate prediction model of sustained postoperative opioid use. Consistent with current standards, 3 they transparently reported the model development process and coefficients. They also translated the model into a practical and accessible scoring system, the Stopping Opioids After Surgery (SOS) score, making it more likely to be used for discharge planning. Others who develop prediction models should emulate these features. Clinical prediction models like the SOS score 2 are intended to inform treatment decisions for individual patients. Therefore, the same rules of evidence and skepticism should apply as for all health care interventions. Because of the complex and technical nature of prediction model development and evaluation, being a critical user of these models is often more difficult than producing the models in the first place. Overall accuracy statistics are important, but they are only a small fraction of what the critical user should consider. In this short commentary, I offer only 3 of the many important questions critical users should ask before using or implementing the SOS score or any other clinical prediction model.

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Can the American College of Surgeons Risk Calculator Predict 30-Day Complications After Knee and Hip Arthroplasty?

Cited by 110 publications

References 26 publications

Can the ACS-NSQIP surgical risk calculator predict post-operative complications in patients undergoing flap reconstruction following soft tissue sarcoma resection?

Can the ACS-NSQIP surgical risk calculator predict post-operative complications in patients undergoing flap reconstruction following soft tissue sarcoma resection?

Pay-for-performance in orthopedics: how we got here and where we are going

Three Critical Questions That Should Be Asked Before Using Prediction Models for Clinical Decision Support

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