Journal of the American College of Surgeons
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American College of Surgeons NSQIP risk-adjustment models rely on the designated "principal" CPT code to account for procedure-related risk. However, if hospitals differ in their propensity to undertake multiple major operations under the same anesthetic, then risk adjustment using only a single code could bias hospital quality estimates. This study investigated this possibility for bias. ⋯ Conditions under which practice-pattern-associated modeling bias might exist appear to be uncommon and to have a small impact on quality assessments for the areas examined. The evidence suggests that, within the American College of Surgeons NSQIP modeling paradigm, the principal CPT code adequately risk adjusts for operative procedure in performance assessments.
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Multicenter Study
Western Validation of a Novel Gastric Cancer Prognosis Prediction Model in US Gastric Cancer Patients.
A novel prediction model for accurate determination of 5-year overall survival of gastric cancer patients was developed by an international collaborative group (G6+). This prediction model was created using a single institution's database of 11,851 Korean patients and included readily available and clinically relevant factors. Already validated using external East Asian cohorts, its applicability in the American population was yet to be determined. ⋯ Our study validates a novel prediction model for gastric cancer in the American patient population. Its superior prediction of the 5-year survival of gastric cancer patients in a large Western cohort strongly supports its global applicability. Importantly, this model allows for accurate prognosis for an increasing number of gastric cancer patients worldwide, including those who received inadequate lymphadenectomy or underwent a noncurative resection.