Prospective Comparison of Clinical Judgment and APACHE II Score in Predicting the Outcome in Critically Ill Surgical Patients

Comparison of the APACHE III, APACHE II and Glasgow Coma Scale in acute head injury for prediction of mortality and functional outcome

“…First, treatment error is not predictable, especially in surgical patients [21]. Second, the data collected on the day of admission may not reflect completely the unforeseen events which may be major determinants of outcome [22].…”

“…Recently, in the evaluation of the APACHE III, Knaus et al [11] suggested that a sequential record of the APACHE scores may yield greater accuracy. Third, for patients who are resuscitated before admission or in the operating room, there may be little physiological abnormality [21]. Fourth, the co-morbidity condition [11] is not taken into account enough in the APACHE system.…”

Diagnosis and Management of Complicated Intra-Abdominal Infection in Adults and Children: Guidelines by the Surgical Infection Society and the Infectious Diseases Society of America

“…These values are captured by severity scoring systems, but for the individual patient, clinical judgment is at least as accurate as a numerical score [1][2][3][4]. ''High risk'' is intended to describe patients with a range of reasons for increased rates of treatment failure in addition to a higher severity of infection, particularly patients with an anatomically unfavorable infection or a health care-associated infection [5] ( Table 1).…”

“…In a guideline on the management of severe pancreatitis, however, the authors concluded that this approach was not justified on the basis of available data [4]. A meta-analysis of trials performed in this area have shown that positive results were attributable to poor study design and that well-designed studies did not demonstrate benefit [164].…”

Mortality predictions in the intensive care unit: Comparing physicians with scoring systems*

“…We constructed separate 2 ϫ 2 tables of predicted mortality by physicians and scoring systems vs. actual mortality for seven studies (2,(17)(18)(19)(20)(21)(22), where true positives represented the number of deaths correctly predicted. Intensivists' (12,17,20) or ICU fellows' (21) predictions were used when more than one physician group provided separately reported predictions.…”