The Thoughtful Intensivist

The Thoughtful Intensivist

SOFA-2: Wild & Wrong

Open your eyes wide when you see a study using SOFA as an outcome

Rafael Olivé Leite's avatar
Rafael Olivé Leite
Jan 03, 2026
∙ Paid

I DEPLORE the commentators who only write nice things. It always seems like blandness, cowardice, sycophancy, or some other obscure trait only Dostoevsky knew. However, the opposite should also be avoided. This is why I will start by praising SOFA-2 with a couple of compliments.

SOFA-2 displays the potential of computer- and internet-powered research in the 21st century. It is no less than a technological and organizational miracle. I thank and applaud you, authors. You are showing us how far we will reach when we start discussing critical care epistemology. Hat-tip to the authors!, says the backscratcher.

However, SOFA-2 reminded us of the cognitive laziness of SOFA's creators. No amount of hard work can save a lazy job. Too bad? Let’s say the premise is WILD AND WRONG.

In this post:

The wild & wrong premise underpinning SOFA

A freshman's mistake with the types of variables

A death blow to internal validity

Run away from studies using SOFA or delta-SOFA as outcomes

No need to search the internet.

You only find it here.


If you are new to The Thoughtful Intensivist, you may want to enjoy the most insightful essays in critical care for two months before billing. However, if you’d rather go straight for a subscription at a 20% perpetual discount, click below.

TWO-MONTH FREE TRIAL

20% OFF FOREVER


This post is for paid subscribers

Already a paid subscriber? Sign in
© 2026 Rafael Olivé Leite · Privacy ∙ Terms ∙ Collection notice
Start your SubstackGet the app
Substack is the home for great culture