Comparing continuous versus categorical measures to assess and benchmark intensive care unit performance

Detalhes bibliográficos
Autor(a) principal: Bastos, Leonardo S. L.
Data de Publicação: 2022
Outros Autores: Wortel, Safira A., Keizer, Nicolette F. de, Bakhshi-Raiez, Ferishta, Salluh, Jorge I. F., Dongelmans, Dave A., Zampieri, Fernando G., Burghi, Gastón, Abu-Hanna, Ameen, Hamacher, Silvio, Bozza, Fernando A., Soares, Marcio
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
DOI: 10.1016/j.jcrc.2022.154063
Texto Completo: https://www.arca.fiocruz.br/handle/icict/53487
Resumo: Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil.
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spelling Bastos, Leonardo S. L.Wortel, Safira A.Keizer, Nicolette F. deBakhshi-Raiez, FerishtaSalluh, Jorge I. F.Dongelmans, Dave A.Zampieri, Fernando G.Burghi, GastónAbu-Hanna, AmeenHamacher, SilvioBozza, Fernando A.Soares, Marcio2022-06-26T19:55:19Z2022-06-26T19:55:19Z2022BASTOS, 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, 20220883-9441https://www.arca.fiocruz.br/handle/icict/5348710.1016/j.jcrc.2022.154063engElsevierComparing continuous versus categorical measures to assess and benchmark intensive care unit performanceinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlePontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil.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.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.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.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.National Intensive Care Evaluation Foundation. Amsterdam UMC location University of Amsterdam. Department of Medical Informatics. Amsterdam, the NetherlandsD'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Brazilian Research in Intensive Care Network (BRICNet). São Paulo, SP, Brazil.Hospital Maciel. Intensive Care Unit. Montevideo, Uruguay.Amsterdam UMC location University of Amsterdam. Department of Medical Informatics. Amsterdam, the Netherlands.Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil.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.D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Brazilian Research in Intensive Care Network (BRICNet). São Paulo, SP, Brazil.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.ICU benchmarkingICU efficiencyIntensive careOutcome metricsQuality indicatorsinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83097https://www.arca.fiocruz.br/bitstream/icict/53487/1/license.txt73c2438d9038594f05d706f987b602c3MD51ORIGINALComparing_Fernando_Bozza_etal_INI_2022.pdfComparing_Fernando_Bozza_etal_INI_2022.pdfapplication/pdf1060007https://www.arca.fiocruz.br/bitstream/icict/53487/2/Comparing_Fernando_Bozza_etal_INI_2022.pdf2fb5b4cd1e0cdac83e16a6c44fe4e9c7MD52icict/534872022-06-26 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dc.title.pt_BR.fl_str_mv Comparing continuous versus categorical measures to assess and benchmark intensive care unit performance
title Comparing continuous versus categorical measures to assess and benchmark intensive care unit performance
spellingShingle Comparing continuous versus categorical measures to assess and benchmark intensive care unit performance
Bastos, Leonardo S. L.
ICU benchmarking
ICU efficiency
Intensive care
Outcome metrics
Quality indicators
title_short Comparing continuous versus categorical measures to assess and benchmark intensive care unit performance
title_full Comparing continuous versus categorical measures to assess and benchmark intensive care unit performance
title_fullStr Comparing continuous versus categorical measures to assess and benchmark intensive care unit performance
title_full_unstemmed Comparing continuous versus categorical measures to assess and benchmark intensive care unit performance
title_sort Comparing continuous versus categorical measures to assess and benchmark intensive care unit performance
author Bastos, Leonardo S. L.
author_facet Bastos, Leonardo S. L.
Wortel, Safira A.
Keizer, Nicolette F. de
Bakhshi-Raiez, Ferishta
Salluh, Jorge I. F.
Dongelmans, Dave A.
Zampieri, Fernando G.
Burghi, Gastón
Abu-Hanna, Ameen
Hamacher, Silvio
Bozza, Fernando A.
Soares, Marcio
author_role author
author2 Wortel, Safira A.
Keizer, Nicolette F. de
Bakhshi-Raiez, Ferishta
Salluh, Jorge I. F.
Dongelmans, Dave A.
Zampieri, Fernando G.
Burghi, Gastón
Abu-Hanna, Ameen
Hamacher, Silvio
Bozza, Fernando A.
Soares, Marcio
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Bastos, Leonardo S. L.
Wortel, Safira A.
Keizer, Nicolette F. de
Bakhshi-Raiez, Ferishta
Salluh, Jorge I. F.
Dongelmans, Dave A.
Zampieri, Fernando G.
Burghi, Gastón
Abu-Hanna, Ameen
Hamacher, Silvio
Bozza, Fernando A.
Soares, Marcio
dc.subject.en.pt_BR.fl_str_mv ICU benchmarking
ICU efficiency
Intensive care
Outcome metrics
Quality indicators
topic ICU benchmarking
ICU efficiency
Intensive care
Outcome metrics
Quality indicators
description Pontifical Catholic University of Rio de Janeiro. Department of Industrial Engineering. Rio de Janeiro, RJ, Brazil.
publishDate 2022
dc.date.accessioned.fl_str_mv 2022-06-26T19:55:19Z
dc.date.available.fl_str_mv 2022-06-26T19:55:19Z
dc.date.issued.fl_str_mv 2022
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv 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
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/53487
dc.identifier.issn.pt_BR.fl_str_mv 0883-9441
dc.identifier.doi.none.fl_str_mv 10.1016/j.jcrc.2022.154063
identifier_str_mv 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
0883-9441
10.1016/j.jcrc.2022.154063
url https://www.arca.fiocruz.br/handle/icict/53487
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/53487/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/53487/2/Comparing_Fernando_Bozza_etal_INI_2022.pdf
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