Risk Prediction Models to Predict Emergency Hospital Admission in Community-dwelling Adults
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
BACKGROUND: Risk prediction models have been developed to identify those at increased risk for emergency admissions, which could facilitate targeted interventions in primary care to prevent these events. OBJECTIVE: Systematic review of validated risk prediction models for predicting emergency hospital admissions in community-dwelling adults. METHODS: A systematic literature review and narrative analysis was conducted. Inclusion criteria were as follows; POPULATION: community-dwelling adults (aged 18 years and above); Risk: risk prediction models, not contingent on an index hospital admission, with a derivation and ≥1 validation cohort; PRIMARY OUTCOME: emergency hospital admission (defined as unplanned overnight stay in hospital); STUDY DESIGN: retrospective or prospective cohort studies. RESULTS: Of 18,983 records reviewed, 27 unique risk prediction models met the inclusion criteria. Eleven were developed in the United States, 11 in the United Kingdom, 3 in Italy, 1 in Spain, and 1 in Canada. Nine models were derived using self-report data, and the remainder (n=18) used routine administrative or clinical record data. Total study sample sizes ranged from 96 to 4.7 million participants. Predictor variables most frequently included in models were: (1) named medical diagnoses (n=23); (2) age (n=23); (3) prior emergency admission (n=22); and (4) sex (n=18). Eleven models included nonmedical factors, such as functional status and social supports. Regarding predictive accuracy, models developed using administrative or clinical record data tended to perform better than those developed using self-report data (c statistics 0.63-0.83 vs. 0.61-0.74, respectively). Six models reported c statistics of >0.8, indicating good performance. All 6 included variables for prior health care utilization, multimorbidity or polypharmacy, and named medical diagnoses or prescribed medications. Three predicted admissions regarded as being ambulatory care sensitive. CONCLUSIONS: This study suggests that risk models developed using administrative or clinical record data tend to perform better. In applying a risk prediction model to a new population, careful consideration needs to be given to the purpose of its use and local factors.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it