Validation of a Sequential Organ Failure Assessment Score using Electronic Health Record Data. J Med Syst 2018 Sep 14;42(10):199
Date
09/16/2018Pubmed ID
30218383Pubmed Central ID
PMC6261278DOI
10.1007/s10916-018-1060-0Scopus ID
2-s2.0-85053293052 (requires institutional sign-in at Scopus site) 9 CitationsAbstract
The sequential organ failure assessment (SOFA) score is a scoring system commonly used in critical care to assess severity of illness. Automated calculation of the SOFA score using existing electronic health record data would broaden its applicability. We performed a manual validation of an automated SOFA score previously developed at our institution. A retrospective analysis of a random subset of 300 patients from a previously published randomized trial of critically ill adults was performed, with manual validation of SOFA scores from the date of initial intensive care unit admission. Spearman's rank correlation coefficient, weighted Cohen's kappa, and Bland-Altman plots were used to assess agreement between manual and electronic versions of SOFA scores and between manual and electronic versions of their individual components. There was high agreement between manual and electronic SOFA scores (Spearman's rank correlation coefficient = 0.90, 95% CI 0.87-0.93). Renal and respiratory components had lower agreement (weighted Cohen's kappa = 0.63, 95% CI 0.53-0.73 for renal; weighted Cohen's kappa = 0.77, 95% CI 0.70-0.84 for respiratory). The area under the receiver operating characteristic curve (AUC) for 30-day in-hospital mortality was 0.77 (95% CI 0.68-0.84) for manual SOFA scores and 0.75 (95% CI 0.66-0.83) for automated SOFA scores. Automatic calculation of SOFA scores from the electronic health record is feasible and correlates highly with manually calculated SOFA scores. Both have similar predictive value for 30-day in-hospital mortality.
Author List
Huerta LE, Wanderer JP, Ehrenfeld JM, Freundlich RE, Rice TW, Semler MW, SMART Investigators and the Pragmatic Critical Care Research GroupAuthor
Jesse Ehrenfeld MD, MPH Sr Associate Dean, Director, Professor in the Advancing a Healthier Wisconsin Endowment department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedElectronic Health Records
Female
Hospital Mortality
Humans
Intensive Care Units
Male
Middle Aged
Organ Dysfunction Scores
Prognosis
ROC Curve
Retrospective Studies
Severity of Illness Index
