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Finally, organisational and administrative models of trauma centres may influence compliance with guidelines [ 19].
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This approach, in the context of translational medicine, could be more effective in the clinic than the existing administrative model of fragmentation into different disciplines.
We call this top-down administrative model of SASAC the "optimum seeking method".
This study compared (1) data accuracy in the administrative HDR database to that in the clinical cardiac surgery database of the Netherlands Association of Cardio-Thoracic Surgery (NVT) and (2) the predictive performance of administrative models to that of the clinical EuroSCORE model.
Although there are advantages to the use of administrative models for benchmarking in cardiac surgery, their calibration and discrimination (and thus performance in benchmarking) is inferior to that of clinical models.
Previous studies reported that much of the predictive performance of risk models is derived from a relatively small number of clinical variables and the predictive performance of administrative models could be improved with the addition of a limited number of clinical variables.
Using a nationwide cohort of cardiac surgery patients, we assessed the accuracy of an administrative database and the predictive performance of administrative models in comparison with a clinical database and the clinical EuroSCORE model.
Discrimination of the models is shown in figure 3. The c-statistics of the administrative models (0.756 0.788) are substantially lower than that of the clinical models (0.838 0.846), indicating inferior discrimination of the administrative models (p<0.001 for all three model pairs).
At national levels, the historical geopolitical circumstances of Central Europe in the 1910s and a commission from the Carnegie Endowment for International Peace enabled Neurath to study war economies as empirical realizations of administrative models (Neurath 1919/1973, 123-157).
It follows from the aforementioned that the inferior discrimination of administrative models (in comparison with clinical models) will result in inferior calibration.
However, the apparent benefits should be carefully weighed against the limitations and drawbacks of administrative models, when compared with clinical models.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com