Trauma audit is commonly focused using a Pre-Chart to illustrate calculations made using the TRISS model. A line is drawn at Ps = 0.5 to divide expected survivors and nonsurvivors. The use of this cut-off in a severel...
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Trauma audit is commonly focused using a Pre-Chart to illustrate calculations made using the TRISS model. A line is drawn at Ps = 0.5 to divide expected survivors and nonsurvivors. The use of this cut-off in a severely injured population was examined. The 'M statistic' for a group of injured patients selectively triaged to a Trauma Centre was calculated. The ideal cut-off point between predicted outcomes when using the TRISS model to focus trauma audit in this population was determined using a Receiver Operating Characteristic (ROC) curve. For this population the TRISS 'M statistic' was 0.71 (indicating a significantly different case mix from the reference database) and the best cut-off point was at Ps = 0.76. Trauma audit in populations with a case mix of injury severity different from the reference database should use a different Ps line to define unexpected outcomes. (C) 1999 Elsevier Science Ltd. All rights reserved.
A high standard of medical practice is a prerequisite of good medical care and clinical governance is the means for ensuring that a high standard is maintained. In February of this year the College issued the followin...
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A high standard of medical practice is a prerequisite of good medical care and clinical governance is the means for ensuring that a high standard is maintained. In February of this year the College issued the following report to its Fellows and Members. The report states unequivocally the College's position on clinical governance and self-regulation and what it expects of individual physicians and their employers in implementing them. Some of the proposals have already been acted upon and are set in train;others will require additional resources and the commitment of the Department of Health and the Trusts.
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