Has Microsoft -« Left Behind Risk Modeling in Cardiac andThoracic Surgery?

Poullis M

This concept paper examines a number of key areascentral to quality and risk assessment in cardiac surgery. Theeffect of surgeon and institutional factors with regard to outcomesin cardiac surgery is utilized to demonstrate the need tosub analyze cardiac surgeons performance in a more sophisticatedmanner than just operation type and patient risk factors, asin current risk models. By utilizing the mathematical/engineeringconcept of Fourier analysis in the breakdown of cardiac surgicalresults the effects of each of the core components that makesup the care package of a patient?s experiences are examined.The core components examined include: institutional, regional,patient, and surgeon effects. The limitations of current additive(Parsonnet, Euroscore) and logistic (Euroscore, Southern ThoracicSociety) regression risk analysis techniques are discussed. Theinadequacy of current modeling techniques is demonstrated viathe use of known medical formula for calculating flow in the internalmammary artery and the calculation of blood pressure. Byexamining the fundamental limitations of current risk analysistechniques a new technique is proposed that embraces modernsoftware computer technology via the use of structured query language.
References:Poullis M Has Microsoft -« Left Behind Risk Modeling in Cardiac andThoracic Surgery? JECT 2011;43:9-Feb
Institution(s):Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool England