Evaluation of acute physiology and chronic health evaluation ii (apache-ii) vs. simplified acute physiology score ii (saps-ii) in an Iranian population: A multi-center prospective cross-sectional evaluation study. Alireza Atashi 1 , Zahra Rahmatinezhad 2 , Fariba Tohidnezhad 2 , Mir Mohammad Miri 3 , Masoumeh Sarbaz 4 , Fatemeh Mehmandoust Klateh 5 , Erfan Ghasemi 6 , Ameen Abu Hanna 7 , Saeid Eslami 2,7,8* 1 e-Health Department, Virtual School, Tehran University of Medical Sciences, Tehran, Iran 2 Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 3 Emam Hossein Hospital, Shahid Beheshti Medical University, Tehran, Iran 4 Department of Medical Records and Health Information Technology, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran 5 Department of Health Information Management, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran 6 Department of biostatistics, school of paramedical sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran 7 Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands 8 Pharmaceutical Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran Abstract Objectives: To evaluate APACHE-II and SAPS-II models in an Iranian population in order to support administrators in realistic planning and quality control process. Design: A prospective cross-sectional evaluation study. Setting: APACHE-II and SAPS-II were calculated for all consecutive admissions to four intensive care referral centers located in the top two most populated cities in Iran, from 2014 to 2017. The mortality rate in Iran and world standard rate were compared based on APACHE-II categories. Finally, the performance of models was assessed. Main outcome measures: Area under the Receiver Operating Characteristics Curve (AUC), the Brier score and Hosmer-Lemeshow (H-L) goodness-of-fit test were employed. Results: For 1946 patients, the overall observed mortality (23.7%) was more than international rates due to APACHE-II categories. The Brier score for APACHE-II and SAPS-II were 0.18 and 0.193, respectively. Although, none of prediction models were fitted to dataset (H-L ρ-value<0.01), both were associated with acceptable AUCs (APACHE-II=0.746 and SAPS-II=0.752). Conclusion: In this study, despite poor performance measures of APACHE-II and SAPS-II as the most used models in Iran, finding recalibrated version of these prediction models in the country is necessary before applying it as a clinical prioritization or quality control tool. Keywords: Intensive care unit, Risk assessment, Prediction models, Performance measures, Iran. Accepted on 16 May, 2020 Highlights • APACHE-II and SAPS-II (esp. the first) are the most used risk model in Iran and due to limitation in resources, evaluating these prediction models is necessary for optimized resource allocation and evidence-based quality assessment. Also, we have lack of multi-center studies in this field. • The observed ICU mortality rates were significantly higher than internationally published standards according to APACHE-II categories. • With regards to poor performance measures of APACHE-II and SAPS-II in our sample, recalibration of current prediction models is considered as an obligatory research question before applying it. Introduction Nowadays, noticing Intensive Care Units (ICUs) as particular units aiming to provide specific health care services to a particular group of patients with common acute disorder, continuous time-limited decision making process remains as a Perspective https://www.alliedacademies.org/journal-intensive-critical-care-nursing/ J Intensive Crit Care Nurs. 2020 Volume 3 Issue 2 1