| Author | Bastos, Leonardo S. L. | |
| Author | Wortel, Safira A. | |
| Author | Keizer, Nicolette F. de | |
| Author | Bakhshi-Raiez, Ferishta | |
| Author | Salluh, Jorge I. F. | |
| Author | Dongelmans, Dave A. | |
| Author | Zampieri, Fernando G. | |
| Author | Burghi, Gastón | |
| Author | Abu-Hanna, Ameen | |
| Author | Hamacher, Silvio | |
| Author | Bozza, Fernando A. | |
| Author | Soares, Marcio | |
| Access date | 2022-06-26T19:55:19Z | |
| Available date | 2022-06-26T19:55:19Z | |
| Document date | 2022 | |
| Citation | BASTOS, Leonardo S. L. et al. Comparing continuous versus categorical measures to assess and benchmark intensive care unit performance. Journal of critical care, v. 70, p. 1-7, 2022 | pt_BR |
| ISSN | 0883-9441 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/53487 | |
| Language | eng | pt_BR |
| Publisher | Elsevier | pt_BR |
| Rights | open access | pt_BR |
| Title | Comparing continuous versus categorical measures to assess and benchmark intensive care unit performance | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1016/j.jcrc.2022.154063 | |
| Abstract | Purpose: To compare categorical and continuous combinations of the standardized mortality ratio (SMR) and the standardized resource use (SRU) to evaluate ICU performance.
Materials and methods: We analysed data from adult patients admitted to 128 ICUs in Brazil and Uruguay (BR/UY) and 83 ICUs in The Netherlands between 2016 and 2018. SMR and SRU were calculated using SAPS-3 (BR/UY) or APACHE-IV (The Netherlands). Performance was defined as a combination of metrics. The categorical combination was the efficiency matrix, whereas the continuous combination was the average SMR and SRU (average standardized ratio, ASER). Association among metrics in each dataset was evaluated using Spearman's rho and R2.
Results: We included 277,459 BR/UY and 164,399 Dutch admissions. Median [interquartile range] ASER = 0.99[0.83-1.21] in BR/UY and 0.99[0.92-1.09] in Dutch datasets. The SMR and SRU were more correlated in BR/UY ICUs than in Dutch ICUs (Spearman's Rho: 0.54vs.0.24). The highest and lowest ASER values were concentrated in the least and most efficient groups. An expert focus group listed potential advantages and limitations of both combinations.
Conclusions: The categorical combination of metrics is easy to interpret but limits statistical inference for benchmarking. The continuous combination offers appropriate statistical properties for evaluating performance when metrics are positively correlated. | pt_BR |
| Affilliation | Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | Amsterdam UMC location University of Amsterdam. Department of Medical Informatics. Amsterdam, the Netherlands / National Intensive Care Evaluation Foundation. Amsterdam UMC location University of Amsterdam. Department of Medical Informatics. Amsterdam, the Netherlands / Amsterdam Public Health. Quality of care. Amsterdam, the Netherlands. | pt_BR |
| Affilliation | Amsterdam UMC location University of Amsterdam. Department of Medical Informatics. Amsterdam, the Netherlands / National Intensive Care Evaluation Foundation. Amsterdam UMC location University of Amsterdam. Department of Medical Informatics. Amsterdam, the Netherlands / Amsterdam Public Health. Quality of care. Amsterdam, the Netherlands. | pt_BR |
| Affilliation | Amsterdam UMC location University of Amsterdam. Department of Medical Informatics. Amsterdam, the Netherlands / National Intensive Care Evaluation Foundation. Amsterdam UMC location University of Amsterdam. Department of Medical Informatics. Amsterdam, the Netherlands / Amsterdam Public Health. Quality of care. Amsterdam, the Netherlands. | pt_BR |
| Affilliation | D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Brazilian Research in Intensive Care Network (BRICNet). São Paulo, SP, Brazil / Program Federal University of Rio de Janeiro. Internal Medicine. PostGraduate. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | National Intensive Care Evaluation Foundation. Amsterdam UMC location University of Amsterdam. Department of Medical Informatics. Amsterdam, the Netherlands | pt_BR |
| Affilliation | D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Brazilian Research in Intensive Care Network (BRICNet). São Paulo, SP, Brazil. | pt_BR |
| Affilliation | Hospital Maciel. Intensive Care Unit. Montevideo, Uruguay. | pt_BR |
| Affilliation | Amsterdam UMC location University of Amsterdam. Department of Medical Informatics. Amsterdam, the Netherlands. | pt_BR |
| Affilliation | Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Brazilian Research in Intensive Care Network (BRICNet). São Paulo, SP, Brazil. | pt_BR |
| Affilliation | D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Brazilian Research in Intensive Care Network (BRICNet). São Paulo, SP, Brazil. | pt_BR |
| Subject | ICU benchmarking | pt_BR |
| Subject | ICU efficiency | pt_BR |
| Subject | Intensive care | pt_BR |
| Subject | Outcome metrics | pt_BR |
| Subject | Quality indicators | pt_BR |
