Wilcox 2019.

Study characteristics
General information	Objective  Prediction model compared Journal Stroke Country USA Study design Prospective existing registry
Participants	Number of included patients 54,717 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 surgical risk score Objective: prediction model compared  Category: prediction model Scale: not applicable Threshold: not applicable Assay/device: not applicable      Predictor 2: ACS‐NSQIP MICA Objective: prediction model compared  Category: prediction model Scale: not applicable Threshold: not applicable Assay/device: not applicable      Predictor 3: MASHOUR  Objective: prediction model compared  Category: prediction model Scale: not applicable Threshold: not applicable Assay/device: not applicable      Predictor 4: CHADS2‐VASC Objective: prediction model compared  Category: prediction model Scale: not applicable Threshold: not applicable Assay/device: not applicable      Predictor 5: CHADS2 Objective: prediction model compared  Category: prediction model Scale: not applicable Threshold: not applicable Assay/device: not applicable
Outcome	Outcome category Stroke Full outcome definition Not applicable Prediction horizon 30‐day events
Analysis	Number of outcomes 1474 Handling missing data Missing data on outcome timing was imputed by median imputation Discrimination reported? Yes Calibration reported? No Reclassification reported? No
PROBAST: Applicability	Domain 1: Participant selection Low Justification: patient selection was appropriate and generalisable to the population used in the RCRI development study Domain 2: Predictors High Justification: different definition for ischaemic heart disease and unclear definition for high‐risk surgery and congestive heart failure Domain 3: Outcome High Justification: outcome is stroke and not MACE Overall judgement High Justification: patients selected were generalisable to the patient population used in the RCRI development study. However, no/unclear information on predictor definitions for some items and other predictors of the original RCRI were not included or had a different definition. In addition, 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	No	Different definition for ischaemic heart disease and unclear definition for high‐risk surgery and congestive heart failure.
Domain 3: Outcome	Yes	Clearly defined outcome definitions and appropriate adjudication of outcomes.
Domain 4:  Analysis	Yes	However, method of handling missing data was not appropriate and no reporting of calibration measures.
Overall judgement	No	Patient selection was appropriate. Outcome definitions were clearly defined and comparable to the definitions used in the development study. However, no/unclear information on predictor definitions for some items and other predictors of the original RCRI were not included or had a different definition. In addition, method of handling missing data was not appropriate and no reporting of calibration measures.