[New Apgar score? A multi-centre study dealing with the evaluation of the neonate NEOMOD scoring system for the first day of life]. / Nove apgar skóre? multicentrická studie hodnocení novorozence skórovacím systémem NEOMOD první den zivota.

OBJECTIVE: To compare the predictive accuracy of the NEOMOD score and the Apgar score as concerns prediction of mortality and affection of the central nervous system (CNS) in neonates. DESIGN: Prospective multi-centre clinical study. SETTING: Mother and Child Care Institute, Prague; Thomayer's Faculty Hospital with a Policlinic, Prague. METHODS: All neonates with a gestation age > or =35 weeks of pregnancy, hospitalised in the intensive care units of the cooperating hospitals in the period 1998-2002, were included in the study. For all the neonates, the NEOMOD score was established in the first 24 hours and the Apgar score was established in the 1st, 5th and 10th minutes of their lives. The aim was to establish the predictive accuracy of the scoring systems for mortality and affection of CNS in the first 28 days of life. RESULTS: 620 patients participated in the study; 16 patients (1.90%) died by the 28h day. The predictive accuracy for mortality expressed as AUS - the area under receiver operating characteristic (ROC) curve reached the highest level for NEOMOD AUC = 0.96. AUC for the Apgar score was 0.84 in the 1st minute; it was 0.84 in the 5th minute and it was 0.88 in the 10th minute. The predictive accuracy for affection of CNS was AUC = 0.76 in the case of NEOMOD; in the case of Apgar, AUC was 0.71, 0.74 and 0.77 in the 1st, 5th and 10th minute, respectively. CONCLUSION: The NEOMOD system proved a high accuracy in the prediction of neonatal mortality in a group of patients with a gestation age > or =35 weeks of pregnancy. The predictive accuracy of NEOMOD was higher than that of the Apgar score. The predictive accuracy of both the NEOMOD and Apgar scores for affection of CNS in the neonatal period was low.

[Principles, methods and use of the National Register of Cardiovascular Interventions]. / Principy, metody a vyuzití Národního registru kardiovaskulárních intervencí.

The goal of cooperative project of the national registry of cardiovascular interventions is analysis of quality of cardiovascular care with risk stratification and assessment of clinical indicators at organizational and individual level. Bayes methodology of stratification and risk prediction is used.

[A system for monitoring quality, outcomes and health care costs]. / Systém sledování kvality, výsledku a nákladu zdravotní péce.

Specialised form of database named DataCube for assessment of quality, outcomes and costs of the healthcare in cardiac surgery was built at the Institute of Clinical and Experimental Medicine (IKEM). Risk stratification of patients was done using Bayes predictive model. Such prediction well correlated with calculated costs. The results achieved promise the system to become an important decision making tool, which may improve identification of high risk patients.