Moderate efficiency of clinicians' predictions decreased for blurred clinical conditions and benefits from the use of BRASS index. A longitudinal study on geriatric patients' outcomes

Giulia Signorini, Jessica Dagani, Viola Bulgari, Clarissa Ferrari, Giovanni De Girolamo

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives Accurate prognosis is an essential aspect of good clinical practice and efficient health services, particularly for chronic and disabling diseases, as in geriatric populations. This study aims to examine the accuracy of clinical prognostic predictions and to devise prediction models combining clinical variables and clinicians' prognosis for a geriatric patient sample. Study Design and Setting In a sample of 329 consecutive older patients admitted to 10 geriatric units, we evaluated the accuracy of clinicians' prognosis regarding three outcomes at discharge: global functioning, length of stay (LoS) in hospital, and destination at discharge (DD). A comprehensive set of sociodemographic, clinical, and treatment-related information were also collected. Results Moderate predictive performance was found for all three outcomes: area under receiver operating characteristic curve of 0.79 and 0.78 for functioning and LoS, respectively, and moderate concordance, Cohen's K = 0.45, between predicted and observed DD. Predictive models found the Blaylock Risk Assessment Screening Score together with clinicians' judgment relevant to improve predictions for all outcomes (absolute improvement in adjusted and pseudo-R2 up to 19%). Conclusion Although the clinicians' estimates were important factors in predicting global functioning, LoS, and DD, more research is needed regarding both methodological aspects and clinical measurements, to improve prognostic clinical indices.

Original languageEnglish
Pages (from-to)51-60
Number of pages10
JournalJournal of Clinical Epidemiology
Volume69
DOIs
Publication statusPublished - Jan 1 2016

Keywords

  • Clinician
  • Geriatric patient
  • Hospitalization
  • Predictive models
  • Prognosis
  • Treatment outcome

ASJC Scopus subject areas

  • Epidemiology

Fingerprint

Dive into the research topics of 'Moderate efficiency of clinicians' predictions decreased for blurred clinical conditions and benefits from the use of BRASS index. A longitudinal study on geriatric patients' outcomes'. Together they form a unique fingerprint.

Cite this