The database can store both objective and subjective risk measures. If there is good evidence that a 'look test' can improve risk assessment, lets get the referring doctor to perform a look test and store the result in the database. In that way the hospital will not have an edge over the risk-adjustment model used in the study.

Edit: Many patients are already assessed by performance status [1]

[1] https://en.wikipedia.org/wiki/Performance_status