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Calibration of the paediatric index of mortality in UK paediatric intensive care units
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  • Published on:
    Authors reply

    Dear Editor

    We agree with Parry and Jones that the quality of life after paediatric intensive care is at least as important as the number of survivors. Indeed, the first study of the quality of life 2-3 years after paediatric intensive care was performed in children in Melbourne (before any paediatric mortality prediction models were available) [1]. Another study of a later cohort is about to be submitted for pu...

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    Conflict of Interest:
    None declared.
  • Published on:
    The Need for Appropriate Statistical Analysis of Severity Scores

    Dear Editor,

    We believe in quantitative, severity and case-mix adjusted pediatric intensive care unit (PICU) evaluations as potential indicators of quality of care. As the director and statistician for Pediatric Intensive Care Unit Evaluations, we have discovered PICUs that have performed poorly as indicated by more deaths than predicted using such methods. When poor performance was discovered, almost all PI...

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    Conflict of Interest:
    None declared.
  • Published on:
    Calibration of the paediatric index of mortality in UK paediatric intensive care units

    Dear Editor,

    Pearson et al should be congratulated on successfully collecting the data required for calculating the PIM Score on 7253 children admitted to 5 UK PICUs.[1] It is re-assuring to note that the authors did not find any systematic differences between these five units in terms of their standardised mortality ratios. Leaving aside the controversies involved in cross-country comparisons, it is further plea...

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    Conflict of Interest:
    None declared.
  • Published on:
    Authors reply

    Dr Tibby and Dr Murdoch note that, in our study of paediatric intensive care units (PICUs) in the UK [1], PIM discriminated well between children who died and children who survived, with an area under the ROC curve of 0.84. However, they are concerned that PIM had "poor calibration" because the standardised mortality rate (SMR) in the UK units was 0.87 (95% CI 0.81-0.94) - that is, the actual number of deaths was only 87...

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    Conflict of Interest:
    None declared.
  • Published on:
    Calibration of the paediatric index of mortality (PIM) score for UK Paediatric Intensive Care
    Dear Editor,

    Pearson and colleagues have presented data highlighting the use of the PIM score as a tool for auditing paediatric intensive care unit (PICU) performance.[1] Whilst we would agree with the authors' message that PIM has many advantages over other scoring systems, we feel that urgent calibration is needed before this tool is adopted as a benchmark for performance indication in the UK. PIM variables were develope...

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    Conflict of Interest:
    None declared.