Transcript riskcalculator.facs.org

SUSP webinar
Mila H. Ju, MD
Jennifer L. Paruch, MD
August 15, 2013
riskcalculator.facs.org
What is the need for risk calculator?
• Informed consent
– Thorough understanding of potential complications with
surgery
• Shared decision making process
– Type of operation
– Or if surgery should be performed at all
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What is the need for risk calculator?
• Information traditionally based on
– Surgeon experience
– Literature
• Single institution studies
• Clinical trials
• And not specific to individual patient
characteristics
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Development of the Risk Calculator
• ACS NSQIP Data (2009-2012)
– 30-day outcomes
– Risk-adjusted using patient demographics,
comorbidities and laboratory values
– Collected by trained and audited surgical clinical
reviewers (SCRs)
– Standardized data definitions
– Captures complications that occur after discharge or at
another hospital
– Superior to administrative data
Lawson et al., Annals of Surgery, December 2012
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Development of the Risk Calculator
• 1,414,006 patients (393 hospitals)
• All surgical subspecialties (1,557 CPT codes)
• 21 pre-operative factors  10 outcomes
• Similar performance to previous,
procedure-specific risk calculators for ACS NSQIP
• Includes new Surgeon Adjustment Score (SAS)
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Demonstration
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Surgeon Adjustment Score
• Surgeons can adjust estimate using clinical judgment
• Risk factors not captured by the Risk Calculator
2 ONE standard deviation above CPT mean
3 TWO standard deviations above CPT mean
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Surgeon Adjustment Score
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Surgeon Adjustment Score
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Surgeon Adjustment Score:
Comments from NSQIP Meeting
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?
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Risk calculator uses patient characteristics.
Help target
patients with
high risks.
From 2012 SUSP presentation by
Dr.Berenholtz and Dr.Goeschel:
The Science of Safety
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Information from Risk Calculator
will help patients get the evidence.
From 2012 SUSP presentation by Dr.Berenholtz:
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Information from Risk Calculator
will help reducing harm.
From 2012 SUSP presentation
by Goeschel, Hobson, Wick,
& Lubomski: CUSP
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• Useful tool
– Informed consent / decision aid
– Prevent / reduce complications
• Easily accessible
– No log-in, no fee
– Just internet connection
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• In the future
– Application for iPad, iPhone, and other smartphones
– PDF, email, or print functions
riskcalculator.facs.org
Mila H. Ju, MD
Jennifer L. Paruch, MD
riskcalculator.facs.org
riskcalculator.facs.org
Are you going to the Annual ACS Clinical
Congress?
(October 6-10, 2013)
Join the SUSP National team for breakfast!
• When: Monday, October 7 @ 6:30am EST
• Where: Renaissance Hotel in DC (room 12 & 13)
• Why: Network with other surgeons participating in
the SUSP project
riskcalculator.facs.org