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(Circulation. 2006;113:456-462.)
© 2006 American Heart Association, Inc.

AHA Scientific Statement

Standards for Statistical Models Used for Public Reporting of Health Outcomes

An American Heart Association Scientific Statement From the Quality of Care and Outcomes Research Interdisciplinary Writing Group: Cosponsored by the Council on Epidemiology and Prevention and the Stroke Council Endorsed by the American College of Cardiology Foundation

Harlan M. Krumholz, MD, FAHA, Chair; Ralph G. Brindis, MD, MPH; John E. Brush, MD; David J. Cohen, MD, MSc; Andrew J. Epstein, PhD; Karen Furie, MD, MPH, FAHA; George Howard, DrPH, FAHA; Eric D. Peterson, MD, MPH; Saif S. Rathore, MS, MPH; Sidney C. Smith, Jr, MD, FAHA; John A. Spertus, MD; Yun Wang, PhD; Sharon-Lise T. Normand, PhD

With the proliferation of efforts to report publicly the outcomes of healthcare providers and institutions, there is a growing need to define standards for the methods that are being employed. An interdisciplinary writing group identified 7 preferred attributes of statistical models used for publicly reported outcomes. These attributes include (1) clear and explicit definition of an appropriate patient sample, (2) clinical coherence of model variables, (3) sufficiently high-quality and timely data, (4) designation of an appropriate reference time before which covariates are derived and after which outcomes are measured, (5) use of an appropriate outcome and a standardized period of outcome assessment, (6) application of an analytical approach that takes into account the multilevel organization of data, and (7) disclosure of the methods used to compare outcomes, including disclosure of performance of risk-adjustment methodology in derivation and validation samples.

Key Words: AHA Scientific Statements • risk adjustment • risk assessment • quality of health care • quality indicators

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