Prediction of outcome from critical illness. A comparison of clinical judgment with a prediction rule.
Quantitative methods to enhance clinical judgment would be of tremendous benefit to physicians caring for the critically ill. The ability of physicians to predict outcome is a logical standard on which to base the prospective evaluation of a prediction rule intended for this clinical use. The APACHE (acute physiology and chronic health evaluation)-II score was compared with critical care physicians' prediction of outcome for a group of patients in a medical intensive care unit. Physicians were significantly better in predicting outcome in the critically ill. However, the APACHE-II score was still a good predictor of outcome in the intensive care unit and, according to analysis using Bayes' theorem, might still be a useful test to support physicians' judgment, especially in patients with a predicted mortality risk of less than 30%.
Brannen
A L
AL
Department of Medicine, University of Alabama at Birmingham.
Godfrey
L J
LJ
Goetter
W E
WE
D001499:Bayes Theorem; D003422:Critical Care; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007600:Judgment; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D012720:Severity of Illness Index