EuroSCORE is the world's most widely
used cardiac surgical risk model,
but it was based on patients operated on in 1995. There is evidence
that it may be out of date. Although it remains powerful in
discriminating between low-risk and high-risk patients, many centres
have reported that for them it overpredicts risk (a few centres still
say it underpredicts risk). We need to find out if the model should be
recalibrated, so we are collecting new data.
Why collect new data? There are so many databases out there already!
We could use existing databases, but
most are not validated and we have
no way of verifying their quality. One of the reasons for the success
of the EuroSCORE model is that it was built on a robust and clean
database, collected by willing volunteer centres. We would like to keep
that standard.
The
Society of Thoracic Surgeons (STS) already has several risk models. Why
do we need to update the EuroSCORE?
We showed in the past that the
EuroSCORE performs as well in Europe as
in North America, where the STS risk models were developed. Although
the STS risk models are widely in use, many cardiac surgery units
prefer the EuroSCORE because it is easier and faster to use.
We participated in the original EuroSCORE data collection. Will this be
the same?
No, it will be much easier! The
differences will be the following:
last time, we asked for nearly 100 data points on each patient.
This time, we ask only for around 20 data points
the data will be similar to data already collected by anyone who
used
EuroSCORE, but there will be some addition and refinement in certain
areas (body mass index, renal function, diabetes and type of surgery
performed). As before, we only ask for data that are widely and readily
available
data collection will be web-based, so that information can be
easily
given online. There will be an option to collect paper-based data for
later online transfer for centres requiring that facility.
Will the data be treated confidentially?
Yes. Patient, centre and surgeon
anonymity is guaranteed to all participants.
I am worried that our results may not be among the best. Should we
participate?
Absolutely! It is vital that the data
come from all types of centre,
and not just so-called centres of excellence. In fact, if only the
centres with the best outcomes participate, the risk model will be a
harsh one on everyone else. To have a good and fair model, it is
important to have a mix of centres, and to ensure that all deaths are
reported.
When
does data collection begin?
The website is under construction and
will be tested to make sure it is
user-friendly and robust. All being well, data collection will begin
early in 2010.
How
long will we have to collect data?
That depends on the number of centres
participating. The more centres,
the quicker the exercise. We already have more than 100 centres
committed to the project, and expect that number to increase very
rapidly with this announcement. If enough centres participate, we may
be able to complete the data collection in less than 3 weeks. The
longest we shall ask for will be 3 months.
What is the project?