Prognostic models in the ICU From development to clinical practice L. Minne, MS Dr. S. Eslami, Phar Dr. D.A. Dongelmans, Prof. Dr. S.E.J.A. de Rooij, Prof. Dr. A. Abu-Han Dept. of Medical Informati Dept. of Intensive Ca Academic Medical Cent Amsterdam, the Netherlan Prof. Dr. E. de Jonge, MD Dept. of Intensive Care Leiden University Medical Center Leiden, the Netherlands
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Prognostic models in the ICU From development to clinical practice L. Minne, MSc. Dr. S. Eslami, PharmD Dr. D.A. Dongelmans, MD Prof. Dr. S.E.J.A. de Rooij,
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Prognostic models in the ICU
From development to clinical practice
L. Minne, MSc.Dr. S. Eslami, PharmD
Dr. D.A. Dongelmans, MDProf. Dr. S.E.J.A. de Rooij, MD
Prof. Dr. A. Abu-Hanna
Dept. of Medical InformaticsDept. of Intensive Care
Academic Medical CenterAmsterdam, the Netherlands
Prof. Dr. E. de Jonge, MDDept. of Intensive CareLeiden University Medical CenterLeiden, the Netherlands
Use of prognostic models
1) Benchmarking
2) Decision-making
Expected mortality: 30% 12%
SMR: 0.83 1.25
Hospital 1 Hospital 2
Observed mortality: 25% 15%
Estimates from prognostic model
Use of prognostic models
Your probability to survive is: -7.7631 + (SAPS II score * 0.0737) + (0.9971 * (ln (SAPS II score + 1)))
1) Benchmarking
2) Decision-making
Barriers for use in clinical practice Lack of evidence for:
External validity Clinical credibility Impact on decisions and patient outcomes
Selffulfilling prophecy
Population level vsindividual level
Overview of our research project
1)1) IdentifyIdentify prognostic models, their validity and use in clinical practice
2) Assess prognostic model behaviour over time + effects on benchmarkingbenchmarking
3) Assess clinicians’ predictions, (need for) prognostic models, their validity and impact in decision-makingdecision-making