The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.
Development and Evaluation of the Universal ACS NSQIP Surgical Risk Calculator: A Decision Aid and Informed Consent Tool for Patients and Surgeons
Open accessAbstract
BACKGROUND: Accurately estimating surgical risks is critical for shared decision making and informed consent. The Centers for Medicare and Medicaid Services may soon put forth a measure requiring surgeons to provide patients with patient-specific, empirically derived estimates of postoperative complications. Our objectives were to develop a universal surgical risk estimation tool, to compare performance of the universal vs previous procedure-specific surgical risk calculators, and to allow surgeons to empirically adjust the estimates of risk. STUDY DESIGN: Using standardized clinical data from 393 ACS NSQIP hospitals, a web-based tool was developed to allow surgeons to easily enter 21 preoperative factors (demographics, comorbidities, procedure). Regression models were developed to predict 8 outcomes based on the preoperative risk factors. The universal model was compared with procedure-specific models. To incorporate surgeon input, a subjective surgeon adjustment score, allowing risk estimates to vary within the estimate's confidence interval, was introduced and tested with 80 surgeons using 10 case scenarios. RESULTS: Based on 1,414,006 patients encompassing 1,557 unique CPT codes, a universal surgical risk calculator model was developed that had excellent performance for mortality (c-statistic = 0.944; Brier score = 0.011 [where scores approaching 0 are better]), morbidity (c-statistic = 0.816, Brier score = 0.069), and 6 additional complications (c-statistics > 0.8). Predictions were similarly robust for the universal calculator vs procedure-specific calculators (eg, colorectal). Surgeons demonstrated considerable agreement on the case scenario scoring (80% to 100% agreement), suggesting reliable score assignment between surgeons. CONCLUSIONS: The ACS NSQIP surgical risk calculator is a decision-support tool based on reliable multi-institutional clinical data, which can be used to estimate the risks of most operations. The ACS NSQIP surgical risk calculator will allow clinicians and patients to make decisions using empirically derived, patient-specific postoperative risks.
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Cites
Assessing the Performance of Prediction Models: A Framework for Traditional and Novel Measures
Steyerberg, E. W., Vickers, A. J., Cook, N. R., Gerds, T., Gonen, M., Obuchowski, N., Pencina, M. J., & Kattan, M. W. (2010) · Epidemiology · doi:10.1097/ede.0b013e3181c30fb2 · Cited by 5,170
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“Data are collected by trained and audited surgical clinical reviewers (SCR) at each individual hospital using data definitions that are standardized across all hospitals.(11) Thirty-day outcomes are ascertained from the medical record or patients are contacted after discharge.”
MethodSelf-citationKramer, A. A., & Zimmerman, J. E. (2007) · Critical Care Medicine · doi:10.1097/01.ccm.0000275267.64078.b0 · Cited by 886
Development and Validation of a Risk Calculator for Prediction of Cardiac Risk After Surgery
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Hall, B. L., Hamilton, B. H., Richards, K., Bilimoria, K. Y., Cohen, M. E., & Ko, C. Y. (2009) · Annals of Surgery · doi:10.1097/sla.0b013e3181b4148f · Cited by 753
Self-citationCohen, M. E., Ko, C. Y., Bilimoria, K. Y., Zhou, L., Huffman, K., Wang, X., Liu, Y., Kraemer, K., Meng, X., Merkow, R., et al. (2013) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2013.02.027 · Cited by 583
Self-citationIngraham, A. M., Richards, K. E., Hall, B. L., & Ko, C. Y. (2010) · Advances in Surgery · doi:10.1016/j.yasu.2010.05.003 · Cited by 534
Self-citationSchenker, Y., Fernandez, A., Sudore, R., & Schillinger, D. (2011) · Medical Decision Making · doi:10.1177/0272989x10364247 · Cited by 445
Cohen, M. E., Bilimoria, K. Y., Ko, C. Y., & Lee Hall, B. (2009) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2009.01.043 · Cited by 364
Self-citationLawson, E. H., Louie, R., Zingmond, D. S., Brook, R. H., Hall, B. L., Han, L., Rapp, M., & Ko, C. Y. (2012) · Annals of Surgery · doi:10.1097/sla.0b013e31826b4c4f · Cited by 342
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Cited by
De Hert, S., Staender, S., Fritsch, G., Hinkelbein, J., Afshari, A., Bettelli, G., Bock, M., Chew, M. S., Coburn, M., De Robertis, E., et al. (2018) · European Journal of Anaesthesiology · doi:10.1097/eja.0000000000000817 · Cited by 389
Bihorac, A., Ozrazgat-Baslanti, T., Ebadi, A., Motaei, A., Madkour, M., Pardalos, P. M., Lipori, G., Hogan, W. R., Efron, P. A., Moore, F., et al. (2019) · Annals of Surgery · doi:10.1097/sla.0000000000002706 · Cited by 377
Thompson, A., Fleischmann, K. E., Smilowitz, N. R., de las Fuentes, L., Mukherjee, D., Aggarwal, N. R., Ahmad, F. S., Allen, R. B., Altin, S. E., Auerbach, A., et al. (2024) · Circulation · doi:10.1161/cir.0000000000001285 · Cited by 365
Diagnosis and Management of Acute Appendicitis in Adults: A Review
Moris, D., Paulson, E. K., & Pappas, T. N. (2021) · JAMA · doi:10.1001/jama.2021.20502 · Cited by 363
Bertsimas, D., Dunn, J., Velmahos, G. C., & Kaafarani, H. M. A. (2018) · Annals of Surgery · doi:10.1097/sla.0000000000002956 · Cited by 321
Metadata
- Authors
- Bilimoria, K. Y., Liu, Y., Paruch, J. L., Zhou, L., Kmiecik, T. E., Ko, C. Y., & Cohen, M. E.
- Venue
- Journal of the American College of Surgeons
- Published
- 2013-11
- Volume
- 217
- Issue
- 5
- Pages
- 833-842e3
- ISSN
- 1072-7515 (ISSN-L)
- OpenAlex
- W2048301249
- Cited by
- 1,905
- References
- 21
- FWCI
- 44.70
- Type
- journal article
- Language
- en
- Open access
- green
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- Bilimoria, K. Y., Liu, Y., Paruch, J. L., Zhou, L., Kmiecik, T. E., Ko, C. Y., & Cohen, M. E. (2013). Development and Evaluation of the Universal ACS NSQIP Surgical Risk Calculator: A Decision Aid and Informed Consent Tool for Patients and Surgeons. Journal of the American College of Surgeons. https://doi.org/10.1016/j.jamcollsurg.2013.07.385
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