当前位置： SCI文献检索 > JOURNAL OF CLINICAL EPIDEMIOLOGY期刊下所有文献 > The importance of severity of illness adjustment in predicting adverse outcomes in the Medicare population.

The importance of severity of illness adjustment in predicting adverse outcomes in the Medicare population.

Abstract：

:The importance of using risk-adjusted mortality rates to measure quality of care is well-established. However, mortality rates may be an insensitive measure of quality for surgical patients since death is a relatively rare outcome. This study used Medicare files to identify, through chart abstraction, clinical postoperative complications of four surgical procedures (n = 8126) that could serve as measures of quality. Disease-specific severity of illness models using a moderate number of clinical variables and admission MedisGroups score models computed from approximately 250 clinical variables were compared in predicting postoperative adverse events. Initial differences between the two models disappeared upon cross-validation. Validated R-squareds and C statistics from models using half the data were generally positive, suggesting that these models had real, although modest, predictive power. We have shown that severity of illness on admission plays a role in predicting adverse events of surgery. Risk-adjusted outcomes may potentially be useful in screening for quality shortfalls.

journal_name

J Clin Epidemiol

journal_title

Journal of clinical epidemiology

authors

Rosen AK,Ash AS,McNiff KJ,Moskowitz MA

doi

10.1016/0895-4356(94)00165-m

subject

Has Abstract

pub_date

1995-05-01 00:00:00

pages

631-43

issue

5

eissn

0895-4356

issn

1878-5921

pii

0895-4356(94)00165-M

journal_volume

48

pub_type

杂志文章

相关文献

JOURNAL OF CLINICAL EPIDEMIOLOGY文献大全
  • Malignant neoplasms in the Japanese community of Hisayama: mortality and changing pattern during a 30-year observation period based on a consecutive autopsy series.

    abstract：:To obtain a relatively true mortality from malignant neoplasms, we studied the frequency of cancers in the different sites and the changing patterns of the frequency and sites over time among residents of the community of Hisayama, where an autopsy-based population survey (autopsy rate, 80%) has been conducted since 1...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/0895-4356(95)00560-9

    authors： Nomiyama K,Ueda K,Kiyohara Y,Kato I,Ohmura T,Iwamoto H,Nakayama K,Ohmori M,Yoshitake T,Sueishi K,Tsuneyoshi M,Fujishima M

    更新日期：1996-01-01 00:00:00

  • Hui and Walter's latent-class reference-free approach may be more useful in assessing agreement than diagnostic performance.

    abstract：BACKGROUND AND OBJECTIVE:Hui and Walter developed a latent class approach to assess the accuracy of a diagnostic procedure when no reference test is available. Our objective was to compare sensitivity and specificity estimates obtained with this reference-free approach and standard approaches, and to examine how and wh...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2004.10.021

    authors： Bertrand P,Bénichou J,Grenier P,Chastang C

    更新日期：2005-07-01 00:00:00

  • OAKHQOL: a new instrument to measure quality of life in knee and hip osteoarthritis.

    abstract：OBJECTIVE:To develop a questionnaire with which to measure quality of life (QoL) in patients with knee and hip osteoarthritis (OA). STUDY DESIGN AND SETTING:Thirty-two caregivers and 96 OA patients were interviewed individually (using cognitive and face-to-face techniques) and in focus groups. A group of experts worki...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章,多中心研究

    doi：10.1016/j.jclinepi.2004.04.011

    authors： Rat AC,Coste J,Pouchot J,Baumann M,Spitz E,Retel-Rude N,Le Quintrec JS,Dumont-Fischer D,Guillemin F

    更新日期：2005-01-01 00:00:00

  • An approach to measuring quality of midwifery care.

    abstract：:In perinatology "Outcome" is almost always defined in terms of mortality or serious morbidity. Evaluation of care for normal pregnancy and midwifery care in particular cannot rely only on outcome measures per se, but must also take the means and interventions by which these are achieved into account. Perinatal Backgro...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/0895-4356(95)00549-8

    authors： Wiegers TA,Keirse MJ,Berghs GA,van der Zee J

    更新日期：1996-03-01 00:00:00

  • Pooled time series regression analysis in longitudinal studies.

    abstract：:Many longitudinal studies attempt to examine changes in outcome measures over time in groups of patients. Applying conventional analytic techniques, such as a single classical linear regression model, to these data will often not result in minimum variance estimates, and may affect the results of tests of significance...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/0895-4356(93)90038-3

    authors： Ward MM,Leigh JP

    更新日期：1993-07-01 00:00:00

  • Most meta-analyses of drug interventions have narrow scopes and many focus on specific agents.

    abstract：OBJECTIVE:To assess the extent to which meta-analysis publications of drugs and biologics focus on specific named agents or even only a single agent, and identify characteristics associated with such focus. STUDY DESIGN AND SETTING:We evaluated 499 articles with meta-analyses published in 2010 and estimated how many d...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章,评审

    doi：10.1016/j.jclinepi.2012.10.014

    authors： Haidich AB,Pilalas D,Contopoulos-Ioannidis DG,Ioannidis JP

    更新日期：2013-04-01 00:00:00

  • Time-related issues with application to health gains and losses.

    abstract：:Time-related aspects of health have attracted increasing interest, and it has become evident that many medical situations concern the exchange of present-day costs for future benefits. Traditional decision analytic paradigms weigh the probability of outcomes and the value of outcomes. Such analyses are incomplete if t...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/s0895-4356(02)00447-x

    authors： Ortendahl M,Fries JF

    更新日期：2002-09-01 00:00:00

  • Test-retest reliability of an epidemiological instrument for Parkinson's disease.

    abstract：:Reliability testing was conducted on a survey instrument for a genetic epidemiological study of Parkinson's disease (PD). Information on demographics, medical history, places of residence, and occupations was collected. The instrument was administered to 11 pairs of siblings discordant for PD and then re-administered ...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/s0895-4356(00)00229-8

    authors： Reider CR,Hubble JP

    更新日期：2000-08-01 00:00:00

  • Cluster-randomized controlled trials evaluating complex interventions in general practices are mostly ineffective: a systematic review.

    abstract：OBJECTIVES:The aim of this study was to evaluate how frequently complex interventions are shown to be superior to routine care in general practice-based cluster-randomized controlled studies (c-RCTs) and to explore whether potential differences explain results that come out in favor of a complex intervention. STUDY DE...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章,评审

    doi：10.1016/j.jclinepi.2017.10.010

    authors： Siebenhofer A,Paulitsch MA,Pregartner G,Berghold A,Jeitler K,Muth C,Engler J

    更新日期：2018-02-01 00:00:00

  • Bayesian methods including nonrandomized study data increased the efficiency of postlaunch RCTs.

    abstract：OBJECTIVES:Findings from nonrandomized studies on safety or efficacy of treatment in patient subgroups may trigger postlaunch randomized clinical trials (RCTs). In the analysis of such RCTs, results from nonrandomized studies are typically ignored. This study explores the trade-off between bias and power of Bayesian RC...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2014.11.015

    authors： Schmidt AF,Klugkist I,Klungel OH,Nielen M,de Boer A,Hoes AW,Groenwold RH

    更新日期：2015-04-01 00:00:00

  • Using the outcome for imputation of missing predictor values was preferred.

    abstract：BACKGROUND AND OBJECTIVE:Epidemiologic studies commonly estimate associations between predictors (risk factors) and outcome. Most software automatically exclude subjects with missing values. This commonly causes bias because missing values seldom occur completely at random (MCAR) but rather selectively based on other (...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2006.01.009

    authors： Moons KG,Donders RA,Stijnen T,Harrell FE Jr

    更新日期：2006-10-01 00:00:00

  • A stroke prediction score in the elderly: validation and Web-based application.

    abstract：:The objective of this study was to construct a prediction model for predicting stroke in an elderly U.S. population, and to assess the accuracy in this population of other previously published prediction models. The subjects were participants in the Cardiovascular Health Study: 2,495 men and 3,393 women age 65 years a...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/s0895-4356(01)00434-6

    authors： Lumley T,Kronmal RA,Cushman M,Manolio TA,Goldstein S

    更新日期：2002-02-01 00:00:00

  • Potentially unnecessary and wasteful clinical trial research detected in cumulative meta-epidemiological and trial sequential analysis.

    abstract：OBJECTIVE:The objective was to estimate the presence and extent to which potentially unnecessary and therefore maybe wasteful clinical trials regarding relevant interventions and outcomes in major clinical areas had been conducted. STUDY DESIGN AND SETTING:From current Cochrane collaboration systematic reviews in majo...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2016.11.003

    authors： Storz-Pfennig P

    更新日期：2017-02-01 00:00:00

  • Systematic reviews of test accuracy should search a range of databases to identify primary studies.

    abstract：OBJECTIVE:To estimate the yield from searching a range of bibliographic databases and additional sources to identify test accuracy studies for systematic reviews. STUDY DESIGN AND SETTING:We examined eight systematic reviews and their database searches: MEDLINE, EMBASE, BIOSIS, Science Citation Index, LILACS, Pascal, ...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2007.05.013

    authors： Whiting P,Westwood M,Burke M,Sterne J,Glanville J

    更新日期：2008-04-01 00:00:00

  • Methods for analyzing matched designs with double controls: excess risk is easily estimated and misinterpreted when evaluating traffic deaths.

    abstract：OBJECTIVES:To demonstrate analytic approaches for matched studies where two controls are linked to each case and events are accumulating counts rather than binary outcomes. A secondary intent is to clarify the distinction between total risk and excess risk (unmatched vs. matched perspectives). STUDY DESIGN AND SETTING...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2018.02.005

    authors： Redelmeier DA,Tibshirani RJ

    更新日期：2018-06-01 00:00:00

  • Systematic reviews do not comment on applicability for primary care.

    abstract：OBJECTIVES:How often authors comment on applicability for primary care in systematic reviews of clinical trials. STUDY DESIGN AND SETTING:We selected 4% of the Cochrane Database for Systematic Reviews (CDSRs; January 2008 to October 2013). We excluded reviews when primary care trials were not eligible. We extracted wh...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2015.06.003

    authors： Missiou A,Tatsioni A

    更新日期：2015-10-01 00:00:00

  • A systematic review of core outcome set development studies demonstrates difficulties in defining unique outcomes.

    abstract：OBJECTIVES:Core outcome set (COS) development often begins with a systematic review to identify outcomes. Reviews frequently show heterogeneity in numbers of outcomes reported across trials. Contributing to this is a lack of a uniform definition for an outcome. This study proposes a first working definition for a uniqu...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2019.06.016

    authors： Young AE,Brookes ST,Avery KNL,Davies A,Metcalfe C,Blazeby JM

    更新日期：2019-11-01 00:00:00

  • Good agreement between parental and self-completed questionnaires about allergic diseases and environmental factors in teenagers.

    abstract：OBJECTIVES:To study whether the methodological change from parent to index subject as questionnaire respondent affected the prevalence estimates and risk factor patterns for allergic diseases in a longitudinal study. STUDY DESIGN AND SETTING:A prospective study of asthma and allergic diseases among children was begun ...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2009.08.017

    authors： Hedman L,Bjerg A,Perzanowski M,Rönmark E

    更新日期：2010-07-01 00:00:00

  • Subgroup analyses of the major clinical endpoints in the Program on the Surgical Control of the Hyperlipidemias (POSCH): overall mortality, atherosclerotic coronary heart disease (ACHD) mortality, and ACHD mortality or myocardial infarction.

    abstract：:The Program on the Surgical Control of the Hyperlipidemias (POSCH) was a secondary atherosclerosis intervention trial employing partial ileal bypass surgery as the intervention modality. For this report, we analyzed 105 subgroups in 35 variables in POSCH, chosen predominantly for their potential relationship to the ri...

    journal_title：Journal of clinical epidemiology

    pub_type： 临床试验,杂志文章,多中心研究,随机对照试验

    doi：10.1016/0895-4356(94)00145-g

    authors： Matts JP,Buchwald H,Fitch LL,Campos CT,Varco RL,Campbell GS,Pearce MB,Yellin AE,Smink RD Jr,Sawin HS Jr

    更新日期：1995-03-01 00:00:00

  • Sieve analysis: methods for assessing from vaccine trial data how vaccine efficacy varies with genotypic and phenotypic pathogen variation.

    abstract：:A key component in the evaluation of efficacy of a vaccine to protect against disease caused by an antigenically diverse infectious pathogen in a preventative vaccine trial is assessing how vaccine-induced protection depends on genotypic and phenotypic variations of the exposing pathogen. This assessment is made by co...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章,评审

    doi：10.1016/s0895-4356(00)00258-4

    authors： Gilbert P,Self S,Rao M,Naficy A,Clemens J

    更新日期：2001-01-01 00:00:00

  • The Chinese version of the Tampa Scale for Kinesiophobia was cross-culturally adapted and validated in patients with low back pain.

    abstract：OBJECTIVES:The aim of the present study was to obtain a cross-cultural adaptation and evaluation of a Simplified Chinese (SC) version of the Tampa Scale for Kinesiophobia (TSK) for use in patients with low back pain (LBP). STUDY DESIGN AND SETTING:The TSK was translated and adapted cross-culturally following internati...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2015.07.003

    authors： Wei X,Xu X,Zhao Y,Hu W,Bai Y,Li M

    更新日期：2015-10-01 00:00:00

  • Use of surrogate respondents in studies of stroke and dementia.

    abstract：:A study was performed to determine the misclassification of information on exposure when surrogate informants are interviewed. Information from nondementia patients admitted to a geriatric ward was compared with that obtained from the patients' family members or friends (informants). Thirty-seven patients were recruit...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/0895-4356(96)00134-5

    authors： Weiss A,Fletcher AE,Palmer AJ,Nicholl CG,Bulpitt CJ

    更新日期：1996-10-01 00:00:00

  • The Indonesian Drug Advisory Committee and the drug approval process.

    abstract：:The Indonesian Food and Drug Agency began to evaluate drug applications in the early 1970s through an Advisory Committee. This was in response to the perestroika-like policy applied to our drug industry; nowadays there are more than 300 drug companies formulating some 13,5600 drug products. During 1977-1988, 603 drugs...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/0895-4356(91)90111-l

    authors： Darmansjah I,Wardhini S

    更新日期：1991-01-01 00:00:00

  • Procedures that assess inconsistency in meta-analyses can assess the likelihood of response bias in multiwave surveys.

    abstract：BACKGROUND AND OBJECTIVE:Response bias may affect the result of surveys with <100% response rate. We applied methods commonly used in meta-analysis to ascertain the extent to which response bias affects multiwave survey results. METHODS:To test hypotheses of between-wave similarity, we used the Cochran-Armitage test f...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2004.11.027

    authors： Montori VM,Leung TW,Walter SD,Guyatt GH

    更新日期：2005-08-01 00:00:00

  • Application of generalizability theory confirmed lower reliability of the standard gamble than the feeling thermometer.

    abstract：OBJECTIVES:Recent studies suggest that rating clinical marker states (CMS) does not improve the measurement properties of the standard gamble (SG) and only slightly improves those of the feeling thermometer (FT). The poor intrarater (test-retest) reliability of CMS may explain their meager performance. Further, lack of...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章,多中心研究

    doi：10.1016/j.jclinepi.2007.03.010

    authors： Schünemann HJ,Norman G,Puhan MA,Ståhl E,Griffith L,Heels-Ansdell D,Montori VM,Wiklund I,Goldstein R,Mador MJ,Guyatt GH

    更新日期：2007-12-01 00:00:00

  • An observational study showed that explaining randomization using gambling-related metaphors and computer-agency descriptions impeded randomized clinical trial recruitment.

    abstract：OBJECTIVES:To explore how the concept of randomization is described by clinicians and understood by patients in randomized controlled trials (RCTs) and how it contributes to patient understanding and recruitment. STUDY DESIGN AND SETTING:Qualitative analysis of 73 audio recordings of recruitment consultations from fiv...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章,多中心研究

    doi：10.1016/j.jclinepi.2018.02.018

    authors： Jepson M,Elliott D,Conefrey C,Wade J,Rooshenas L,Wilson C,Beard D,Blazeby JM,Birtle A,Halliday A,Stein R,Donovan JL,CSAW study group.,Chemorad study group.,POUT study group.,ACST-2 study group.,OPTIMA prelim study group.

    更新日期：2018-07-01 00:00:00

  • Different methods to assess quality of life from multiple follow-ups in a longitudinal asthma study.

    abstract：BACKGROUND AND OBJECTIVE:Serial measurements obtained during observational longitudinal studies offer the opportunity to describe the effects of chronic diseases on patient-centered outcomes such as quality of life. The purpose of this study was to assess serial Asthma Quality of Life Questionnaire (AQLQ) and SF-36 sco...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/S0895-4356(03)00248-8

    authors： Mancuso CA,Peterson MG

    更新日期：2004-01-01 00:00:00

  • Cyclic seasonal variation in plasma lipid and lipoprotein levels: the Lipid Research Clinics Coronary Primary Prevention Trial Placebo Group.

    abstract：:Seasonal plasma lipid and lipoprotein cycles were studied in 1446 hypercholesterolemic 35-59 year-old men followed for 7 years as the placebo group of the Lipid Research Clinics (LRC) Coronary Primary Prevention Trial (CPPT). Separate periodic time series were calculated for each study participant; mean parameter esti...

    journal_title：Journal of clinical epidemiology

    pub_type： 临床试验,杂志文章,随机对照试验

    doi：10.1016/0895-4356(88)90120-5

    authors： Gordon DJ,Hyde J,Trost DC,Whaley FS,Hannan PJ,Jacobs DR,Ekelund LG

    更新日期：1988-01-01 00:00:00

  • Insulin sensitivity markers: predictors of accidents and suicides in Helsinki Heart Study screenees.

    abstract：:The purpose of this study was to evaluate whether elements signifying relative insulin sensitivity (IS) were prospectively linked to accidents and suicides in 14,976 Helsinki Heart Study (HHS) screenees. The main outcome measure was hospitalizations and deaths from accidents and suicide attempts determined from Finnis...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/s0895-4356(02)00407-9

    authors： Golomb BA,Tenkanen L,Alikoski T,Niskanen T,Manninen V,Huttunen M,Mednick SA

    更新日期：2002-08-01 00:00:00

  • The Singaporean English and Chinese versions of the EQ-5D achieved measurement equivalence in cancer patients.

    abstract：OBJECTIVE:To assess measurement equivalence of the Singaporean English and Chinese versions of the EuroQol Group's 5-domain questionnaire (EQ-5D) in cancer patients. STUDY DESIGN AND SETTING:Seven hundred and seventy-one ethnic Chinese patients in Singapore were recruited, and they answered either an English or a Chin...

    journal_title：Journal of clinical epidemiology

    pub_type： 杂志文章

    doi：10.1016/j.jclinepi.2008.03.007

    authors： Gao F,Ng GY,Cheung YB,Thumboo J,Pang G,Koo WH,Sethi VK,Wee J,Goh C

    更新日期：2009-02-01 00:00:00