Key result
Automated EHR risk score shows comparable performance to Epic model for 30-day HF readmission.
Why the study?
Current 30-day heart failure readmission risk models, including Epic's, demonstrate only modest to moderate discriminatory ability, necessitating improved predictive tools.
Observational
Absolute Event Rate: 0.76% vs 0.74%
p-value: p=0.41
An independently derived EHR-automatable model for predicting 30-day heart failure readmissions performs comparably to the proprietary Epic model, providing a foundation for future integration of AI-based diagnostics.
May enable customized EHR tools for HF readmission risk; leaves open effects on outcomes or implementation.
BACKGROUND: Risk scores aim to predict 30-day heart failure (HF) readmissions. PROJECT RATIONALE: Current models, including Epic's Risk of Unplanned Readmission for a 30-Day Event, demonstrate modest to moderate discriminatory ability (area under the curve: 0.59-0.72). PROJECT SUMMARY: The goals of this study were to create an electronic health record (EHR)-automatable 30-day HF readmission risk calculator; to test the accuracy of Epic's model to predict 30-day HF readmission risk; and to compare the 2 models. To derive our EHR-automatable model using machine learning, we first performed a systematic review of 30-day HF risk prediction models. We then compared the predictive capabilities of the Epic model with our model. The Epic model had a C-statistic of 0.74, and the derived EHR risk score had a C-statistic of 0.76 (P = 0.41), suggesting comparable performance. TAKE-HOME MESSAGES: Risk scores are fundamental for personalization of care to accelerate resources for those who need them most. Although both models had moderate discrimination in predicting 30-day HF readmission, the independently derived model provides a platform for future enhancement, such as the inclusion of electrocardiogram-based artificial intelligence diagnostics.
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Withers et al. (2026) conducted an observational in Heart failure. Derived EHR-automatable risk score vs. Epic's risk model was evaluated on Predictive capability (C-statistic) for 30-day HF readmission (p=0.41). A newly derived EHR-automatable risk score for 30-day heart failure readmission showed comparable predictive performance to the Epic model (C-statistic 0.76 vs 0.74, P=0.41).
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