In our earlier study of comparative ICU outcomes between Japan and the United States, we applied strictly a predictive model developed using US patients, unaltered, in a direct comparison of performance between a set of Japanese and US hospitals. This application of severity of illness and risk-stratification tools is one of several approaches to assessing performance across international boundaries, allowing a relative comparison of outcomes by setting the standard for one country as the benchmark for another. This of course does not imply that the reference benchmark is the preferred standard but rather allows for a common point for comparison. canadian pharmacy
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