Expected clinical utility of automatable prediction models for improving palliative and end-of-life care outcomes: Toward routine decision analysis before implementation.

ABSTRACT:

Objective

The study sought to evaluate the expected clinical utility of automatable prediction models for increasing goals-of-care discussions (GOCDs) among hospitalized patients at the end of life (EOL).

Materials and methods

We built a decision model from the perspective of clinicians who aim to increase GOCDs at the EOL using an automated alert system. The alternative strategies were 4 prediction models-3 random forest models and the Modified Hospital One-year Mortality Risk model-to generate alerts for patients at a high risk of 1-year mortality. They were trained on admissions from 2011 to 2016 (70 788 patients) and tested with admissions from 2017-2018 (16 490 patients). GOCDs occurring in usual care were measured with code status orders. We calculated the expected ris

SUBMITTER: Taseen R 

PROVIDER: S-EPMC8510333 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature