Intensive Care Medicine

, Volume 21, Issue 9, pp 770–776

Outcome prediction for individual intensive care patients: Useful, misused, or abused?

  • S. Lemeshow
  • J. Klar
  • D. Teres
Review Article

DOI: 10.1007/BF01704747

Cite this article as:
Lemeshow, S., Klar, J. & Teres, D. Intensive Care Med (1995) 21: 770. doi:10.1007/BF01704747

Abstract

Probabilities of hospital mortality provide meaningful information in many contexts, such as in discussions of patient prognosis by intensive care physicians, in patient stratification for analysis of clinical trial data by researchers, and in hospital reimbursement analysis by insurers. Use of probabilities as binary predictors based on a cut point can be misleading for making treatment decisions for individual patients, however, even when model performance is good overall. Alternative models for estimating severity of illness in intensive care unit (ICU) patients, while demonstrating good agreement for describing patients in the aggregate, are shown to differ considerably for individual patients. This suggests that identifying patients unlikely to benefit from ICU care by using models must be approached with considerable caution.

Key words

ICU models Model calibration Mortality prediction Probability models Severity of illness 

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Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • S. Lemeshow
    • 1
  • J. Klar
    • 1
  • D. Teres
    • 2
    • 3
  1. 1.School of Public Health, Arnold HouseUniversity of MassachusettsAmherstUSA
  2. 2.Critical Care DivisionBaystate Medical CenterSpringfield
  3. 3.School of MedicineTufts UniversityBostonUSA

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