Effect of changes over time in the performance of a customized SAPS-II model on the quality of care assessment

Minne, L., Eslami, S., de Keizer, N., de Jonge, E., de Rooij, S. E. & Abu-Hanna, A., Jan-2012, In : Intensive Care Medicine. 38, 1, p. 40-46 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • Lilian Minne
  • Saeid Eslami
  • Nicolette de Keizer
  • Evert de Jonge
  • Sophia E. de Rooij
  • Ameen Abu-Hanna

Purpose: The aim of our study was to explore, using an innovative method, the effect of temporal changes in the mortality prediction performance of an existing model on the quality of care assessment. The prognostic model (rSAPS-II) was a recalibrated Simplified Acute Physiology Score-II model developed for very elderly Intensive Care Unit (ICU) patients. Methods: The study population comprised all 12,143 consecutive patients aged 80 years and older admitted between January 2004 and July 2009 to one of the ICUs of 21 Dutch hospitals. The prospective dataset was split into 30 equally sized consecutive subsets. Per subset, we measured the model's discrimination [area under the curve (AUC)], accuracy (Brier score), and standardized mortality ratio (SMR), both without and after repeated recalibration. All performance measures were considered to be stable if 1 without and after repeated recalibration for the year 2009. Results: For all subsets, the AUCs were stable, but the Brier scores and SMRs were not. The SMR was downtrending, achieving levels significantly below 1. Repeated recalibration rendered it stable again. The proportions of hospitals with SMR>1 and SMR

Original languageEnglish
Pages (from-to)40-46
Number of pages7
JournalIntensive Care Medicine
Issue number1
Publication statusPublished - Jan-2012
Externally publishedYes


  • Mortality prediction, Prognostic models, Intensive care, Temporal validation, Predictive performance, Elderly patients, PROGNOSTIC MODELS, UNITS, MULTICENTER, MEDICINE

ID: 34072392