A prospective evaluation of computerized estimates of risk in the management of obstructive jaundice.

This article reports on a prospective study of 46 patients who had undergone treatment for obstructive jaundice. Previously described computer estimates of risk were calculated, as were the K value and the mortality index. The computer was no more accurate than an experienced clinician in the prediction of morbidity. In the prediction of mortality, however, the computer was far more accurate than the clinician. Clinical prediction of mortality was associated with a risk ratio of 3.2, a critically elevated K value with a risk ratio of 21.7, and an elevated mortality index with a risk ratio of at least 70. In conclusion, both measures have some use in providing objective measures of stratification among patients with jaundice. The mortality index is also useful in the determination of a program for clinical management and, in particular, the timing of any surgical intervention.