Proposal for a Concise Method to Explore Reasonable Cutoffs from Clinical Databases by Exploiting Serial Testing

In clinical practice, medical professionals are likely to rely on various scoring systems and their suggested cutoffs to evaluate the severity of disease or the risk to patients and the key of scoring system and database is the reliable cutoff. We herein report a novel and concise method to calculate the significant cutoff by exploiting serial testing with the result of tricuspid valve surgery. In tricuspid surgery, tricuspid annuloplication with annuloplasty ring has been common procedure to fix tricuspid regurgitation, but the optimal ring size has not been determined. We defined the new index TARI (Tricuspid Annuloplasty Ring size Index), which normalizes the ring size by body surface area. We tested all cutoff candidates of TARI sequentially and confirmed which value was the most significant cutoff to achieve the best result. Our method would be simple and be widely applicable for any dataset that has negative or positive correlations.