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December 1, 1987Archives of Internal Medicine

Why predictive indexes perform less well in validation studies. Is it magic or methods?

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Why the study?

Do methodological differences in surveillance and outcome definitions explain the deterioration of predictive indexes in validation studies?

Population

232 patients undergoing noncardiac surgery

Design

Cohort

Authors

MCM. E. Charlson

Discussion

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Implication

Methodological variations may explain inconsistent Goldman index performance; leaves open whether true deterioration occurs in validation studies.

Structured PICO

Do methodological differences in surveillance and outcome definitions explain the deterioration of predictive indexes in validation studies?

P
Population
232 patients undergoing noncardiac surgery
I
Intervention
Application of Goldman's cardiac risk index using varying methodological criteria (population assembly, postoperative surveillance, and criteria for cardiac complications)
O
Outcome
Cardiac complication rates

Discrepancies in the performance of prognostic indexes in validation studies may arise from methodological differences in surveillance and outcome definitions rather than inevitable deterioration.

Cite This Study

M. E. Charlson (1987) studied this question.

synapsesocial.com/papers/6a8bcebc2ff0ab4f91e95ba1https://doi.org/10.1001/archinte.147.12.2155
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prospective assessment of different indices of cardiac risk for patients undergoing noncardiac surgeries2002 · 22 citations
  2. 2Prospective Evaluation of Cardiac Risk Indices for Patients Undergoing Noncardiac Surgery2000 · 153 citations
  3. 3Impact of Choice of Risk Model in Perioperative Guidelines: Comment2019
  4. 4Can ASA grade or Goldman's cardiac risk index predict peri‐operative mortality? A study of 16 227 patients1997 · 153 citations
  5. 5Cardiac risk in noncardiac surgical procedures1987 · 1 citations