Medical Data Research Center, Providence Health & Services, Portland, Oregon, USA.
Ann Thorac Surg. 2010 Mar;89(3):677-82. doi: 10.1016/j.athoracsur.2009.10.078.
The Society of Thoracic Surgeons National Adult Cardiac Surgery Database (STS NCD) has become the national benchmark for cardiac surgery reporting. Several important aspects of its risk-adjustment reporting are discussed, with special emphasis on using the reported individual STS risk scores for analysis and evaluation: (1) Different risk models are used in different STS NCD versions. (2) STS calibrates risk scores annually to make the annual predicted rates equal the observed rates. (3) The risk scores given by the STS, whether in the approved STS data collection software programs, published risk models, or online calculator, are not calibrated. (4) The end-user is required to calibrate the STS risk scores before using them. (5) After calibration, the STS predicted risk for any given patient is usually smaller, sometimes less than half of the uncalibrated value. (6) STS uses an observed/expected ratio method to calibrate the risk scores; for technical reasons, it is preferable to use an odds ratio method.
胸外科医师学会国家成人心脏手术数据库（STS NCD）已成为心脏手术报告的国家基准。本文讨论了其风险调整报告的几个重要方面，特别强调使用报告的 STS 个体风险评分进行分析和评估：（1）不同的 STS NCD 版本使用不同的风险模型。（2）STS 每年对风险评分进行校准，以使年度预测率与实际率相等。（3）STS 提供的风险评分（无论是在批准的 STS 数据收集软件程序、发布的风险模型还是在线计算器中）都未经校准。（4）用户在使用 STS 风险评分之前需要对其进行校准。（5）校准后，任何给定患者的 STS 预测风险通常较小，有时不到未经校准值的一半。（6）STS 使用观察/预期比方法来校准风险评分；出于技术原因，最好使用优势比方法。
