What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

Mitchell M. Levy; John Rapoport; Stan Lemeshow; Gary Phillips; Donald B. Chalfin; Marion Danis

doi:10.7326/0003-4819-149-10-200811180-00023

Letters |18 November 2008

What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

Mitchell M. Levy, MD; John Rapoport, PhD; Stan Lemeshow, PhD; Gary Phillips, MAS; Donald B. Chalfin, MD, MS; Marion Danis, MD

Mitchell M. Levy, MD

From Rhode Island Hospital, Providence, RI 02903; Mount Holyoke College, South Hadley, MA 01077; Ohio State University College of Health, Columbus, OH 43210; Abbott Point of Care, East Windsor, NJ 08520; and National Institutes of Health, Bethesda, MD 20892.

John Rapoport, PhD

Stan Lemeshow, PhD

Gary Phillips, MAS

Donald B. Chalfin, MD, MS

Marion Danis, MD

Article, Author, and Disclosure Information

IN RESPONSE:

We agree with and appreciate several of the thoughtful comments offered by the authors of these letters. Most of these comments have been mentioned in the Discussion section of our paper. We would like to make some important points for clarification.

Recalibration was necessary for the severity model. For this reason, we used an expanded SAPS II for severity adjustment in our study. We believe that Figure 1 in our article, along with the reported value for the HosmerLemeshow goodness-of-fit statistic, demonstrates the usefulness of the expanded SAPS II for predicting actual mortality in the population used in our study.

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2008 American College of Physicians

Letters |18 November 2008

What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

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Letters |18 November 2008

What Conclusions Should Be Drawn between Critical Care Physician Management and Patient Mortality in the Intensive Care Unit?

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