• Jack E Zimmerman and Andrew A Kramer.
• aAnesthesiology and Critical Care Medicine, The George Washington University, Washington, District of Columbia bCerner Corporation, Vienna, Virginia, USA.
• Curr Opin Crit Care. 2014 Oct 1;20(5):550-6.

Purpose Of ReviewThere 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 FindingsWe 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.SummaryThere 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.

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