Gupta 2011.

Study characteristics
General information	Objective  Prediction model compared Journal Circulation Country USA Study design Prospective existing registry
Participants	Number of included patients 26,183 Surgical specialty Noncardiac surgery Age Not reported Male sex Not reported  High‐risk surgery Not reported Insulin‐dependent diabetes mellitus Not reported History of ischaemic heart disease Not reported  History of congestive heart failure Not reported History of cerebrovascular events Not reported Elevated creatinine Not reported 0 RCRI factors Not reported 1 RCRI factor Not reported 2 RCRI factors Not reported 3 or more RCRI factors Not reported
Predictors	Predictor 1: ACS‐NSQIP‐MICA Objective: prediction model compared Category: prediction model Scale: not applicable Threshold: not applicable Assay/device: not applicable
Outcome	Outcome category Myocardial infarction and cardiac arrest Full outcome definition Not applicable Prediction horizon 30‐day events
Analysis	Number of outcomes Not reported   Handling missing data No information on handling missing data Discrimination reported? Yes Calibration reported? Yes   Reclassification reported? No
PROBAST: Applicability	Domain 1: Participant selection Low Justification:  Domain 2: Predictors Unclear Justification: no information on how the RCRI predictors were defined Domain 3: Outcome High Justification: outcome is myocardial infarction and cardiac arrest, which is not the outcome for which the RCRI is developed Overall judgement High Justification: patients selected were generalisable to the patient population used in the RCRI development study. However, there was no/unclear information on predictor definitions and outcome definition was different compared to the development study
Notes	—
Item	Authors' judgement	Support for judgement
Domain 1: Participant selection	Yes	Appropriate participant selection in which patients were selected in whom the RCRI model can be applied.
Domain 2: Predictors	Unclear	No information on how the RCRI predictors were defined.
Domain 3: Outcome	Yes	Clearly defined outcome definitions and appropriate adjudication of outcomes.
Domain 4:  Analysis	No	Number of outcomes is not reported; calibration and discrimination was reported. Development of a new model was reported and validated in a new model. However, no calibration plot was reported for the NSQIP‐MICA model in the validation set and no information on the confidence intervals or standard errors was reported.
Overall judgement	No	Patient selection was appropriate. Outcomes were clearly defined and assessed. However, predictor definitions were not clear/reported. Furthermore, the number of outcomes was not reported and inappropriate reporting of performance measures.