How this model should be used:
The PREOP scoring system can easily be implemented into daily practice as a screening measure, to support the judgment of the clinician. The high negative predictive value indicates that the scoring system can exclude the fit elderly from further evaluation, whilst a positive score might indicate that a more comprehensive assessment by a geriatrician or by means of a multidisciplinary meeting is indicated.
Strenghts and weaknesses:
A strength of the PREOP-study is its prospective and comprehensive design. A large number of medical centers participated, which further enhances the generalisability of the results. Selection bias is a limitation of the underlying study as inclusion of a consecutive series of patients cannot be guaranteed. Furthermore, cultural differences could have influenced the reporting of results and answers to questionnaires.
Assessement of model performance:
The AUC for this individual risk score was 0.81 (95% CI: 0.75-0.86). Based on the ROC, a cut-off point was set at >8, with a sensitivity of 78.7% and a specificity of 73.4%. Positive and negatieve predictive values were 40.3% and 93.8%, respectively.
Source:
This model is provided for educational, training and information purposes. It must not be used to support medical decision making, or to provide medical or diagnostic services. Read our full disclaimer.
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