Chest 05/21/2002 By Robert Short
Doctors may drastically overestimate the probability of severe complication for acute
congestive heart failure, possibly resulting in over-use of scarce critical-care resources.
Wally Smith. MD and colleagues at the Division of Quality Health Care, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, set up a prospective cohort study to examine the prognostic judgments and triage decisions of
doctors for patients with acute congestive heart failure.
Death or severe complications was seen in 43 out of 1,032 patients (4.2 percent). A calibration curve stratifying these judgements by decile showed that the doctors consistently overestimated the probability of death or severe complication. Dr Smith said, “Physicians’ judgements were only moderately good at discriminating which patients would have the outcome.”
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