The APACHE II Score is the most-referenced risk score for ICU mortality, with over 15,000 citations in PubMed since its publication 22 years ago, and is still used today both clinically and in research. We talked with Dr. William Knaus, first author on the APACHE paper, about his experience in developing the APACHE II Score, as well as the increasing need for technology in healthcare (and its disappointing uptake and implementation).
Dr. William Knaus
When we started [developing APACHE] in the 1970s, DRGs [diagnosis-related groups] were just coming on the scene, and obviously they were oriented towards the business and financing aspects of healthcare. There’s little correlation to the clinical. But people were relying on DRGs as a way to classify and identify patients, especially in the ICU. So it was important at that time to not so much reinvent the diagnostic system, but to talk about how patients come in at different levels of severity. And at that time, there was really nothing out there. Continue reading “Insights from Dr. William Knaus, Creator of the APACHE II Score”
Dr. Paul Marik
On April 7, 2017, Paging MDCalc published an interview with three critical care experts regarding the Marik et al study on vitamin C in sepsis. Here is Dr. Marik’s response:
There are $20 billion reasons why there are so many skeptics, and they simply don’t understand the enormous body of research. We did not suck this out of thin air. I really don’t mind the skeptics; it generates discussion, and has raised awareness of the treatment and sepsis (that’s good). Unfortunately, patients will die while skeptics debate its merits. Continue reading “Dr. Paul Marik Responds: Vitamin C in Sepsis”
See Dr. Marik’s response to this article.
A recent small single-center before-and-after trial by Marik et al showed that vitamins in combination with other relatively safe therapies may improve outcomes in sepsis. We asked three critical care physicians to give their thoughts on the debate on vitamin C in sepsis, and our own co-founder and healthcare finance expert Joe Habboushe to weigh in on the cost/price argument. Continue reading “First Scurvy, Now Sepsis: Is Vitamin C the New Old Wonder Drug?”
Ah, sepsis. You can’t solve a problem without defining it, and sepsis has been notoriously difficult to define, let alone treat. The body of data on sepsis is growing, as well as laypeople’s awareness of the disease. Yet it still manages to elude clinicians in many ways. We talked to Dr. Christopher Seymour, Sepsis-3 investigator and creator of the qSOFA Score, about using qSOFA to help in the management of sepsis.
Bonus: We also asked Dr. Seymour about his thoughts on vitamin C in sepsis. Come back to Paging MDCalc next week to see what he (and other critical care docs) had to say! Continue reading “Insights from Dr. Christopher Seymour, Creator of the qSOFA Score”
After a lot of hard work from MDCalc’s development team, we released Version 3.0 of MDCalc.com in January and just this past weekend we launched a few updates with Version 3.1. The new site offers a lot of great new features and customization that make using MDCalc even easier. Let’s jump into it! Continue reading “Tricks Up our New Website’s Sleeve: Version 3.1 is Here!”