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A history of outcome prediction in the ICU

Zimmerman, Jack E.a,b; Kramer, Andrew A.b

Current Opinion in Critical Care: October 2014 - Volume 20 - Issue 5 - p 550–556
doi: 10.1097/MCC.0000000000000138
CRITICAL CARE OUTCOMES: Edited by Jeremy M. Kahn

Purpose of review There are few first-hand accounts that describe the history of outcome prediction in critical care. This review summarizes the authors’ personal perspectives about the development and evolution of Acute Physiology and Chronic Health Evaluation over the past 35 years.

Recent findings We emphasize what we have learned in the past and more recently our perspectives about the current status of outcome prediction, and speculate about the future of outcome prediction.

Summary There is increasing evidence that superior accuracy in outcome prediction requires complex modeling with detailed adjustment for diagnosis and physiologic abnormalities. Thus, an automated electronic system is recommended for gathering data and generating predictions. Support, either public or private, is required to assist users and to update and improve models. Current outcome prediction models have increasingly focused on benchmarks for resource use, a trend that seems likely to increase in the future.

aAnesthesiology and Critical Care Medicine, The George Washington University, Washington, District of Columbia

bCerner Corporation, Vienna, Virginia, USA

Correspondence to Andrew A. Kramer, PhD, Senior Research Manager, 1953 Gallows Road, Suite 500, Vienna, VA 22182, USA. Tel: +1 703 245 8147; fax: +1 936 7447; e-mail: akramer@cerner.com

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins