Why the study?
Most prognostic tools for heart failure rely on proportional hazard models, whereas non-linear machine learning algorithms may overcome the limitation of the time-independent hazard ratio assumption.
Do non-linear machine learning survival models improve prediction of readmission or mortality compared to traditional multivariate Cox regression in hospitalized heart failure patients?
Cohort (n=1,796)
No
Do non-linear machine learning survival models improve prediction of readmission or mortality compared to traditional multivariate Cox regression in hospitalized heart failure patients?
This study evaluates whether non-linear machine learning algorithms can overcome the limitations of traditional proportional hazards models for predicting readmission or mortality in heart failure patients.
Non-linear ML models may improve HF readmission and mortality prediction; leaves open external validation before clinical adoption.
Although many models are available to predict prognosis of heart failure patients, most tools combining survival analysis are based on proportional hazard model. Non-linear machine learning algorithms would overcome the limitation of the time-independent hazard ratio assumption and provide more information in readmission or mortality prediction among heart failure patients. The present study collected the clinical information of 1796 hospitalized heart failure patients surviving during hospitalization in a Chinese clinical center from December 2016 to June 2019. A traditional multivariate Cox regression model and three machine learning survival models were developed in derivation cohort. Uno's concordance index and integrated Brier score in validation cohort were calculated to evaluate the discrimination and calibration of different models. Time-dependent AUC and Brier score curves were plotted to assess the performance of models at different time phases.
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Tong et al. (2023) conducted a cohort in Heart failure (n=1,796). Non-linear machine learning survival models vs. Traditional multivariate Cox regression model was evaluated on Readmission or mortality.
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