Details

Autor(en) / Beteiligte

• Romero-Brufau, Santiago
• Huddleston, Jeanne M
• Escobar, Gabriel J
• Liebow, Mark

Titel

Why the C-statistic is not informative to evaluate early warning scores and what metrics to use

Ist Teil von

• Critical care (London, England), 2015-08, Vol.19 (1), p.285-285, Article 285

Ort / Verlag

England: BioMed Central Ltd

Erscheinungsjahr

2015

Link zum Volltext

Quelle

SpringerLink

Beschreibungen/Notizen

• Metrics typically used to report the performance of an early warning score (EWS), such as the area under the receiver operator characteristic curve or C-statistic, are not useful for pre-implementation analyses. Because physiological deterioration has an extremely low prevalence of 0.02 per patient-day, these metrics can be misleading. We discuss the statistical reasoning behind this statement and present a novel alternative metric more adequate to operationalize an EWS. We suggest that pre-implementation evaluation of EWSs should include at least two metrics: sensitivity; and either the positive predictive value, number needed to evaluate, or estimated rate of alerts. We also argue the importance of reporting each individual cutoff value.