Zhenyue Gao, Xiaoli Liu, Yu Kang, Pan Hu, Xiu Zhang, Wei Yan, Muyang Yan, Pengming Yu, Qing Zhang, Wendong Xiao, Zhengbo Zhang
Improving the Prognostic Evaluation Precision of Hospital Outcomes for Heart Failure Using Admission Notes and Clinical Tabular Data: Multimodal Deep Learning Model
Journal of medical Internet research
screening program recommended chronic obstructive pulmonary disease copd adults based current clinical practice guidelines risk prediction models copd developed western settings may directly applicable older chinese adults evaluate performance existing risk prediction model copd developed western setting chinese adults investigate whether new risk prediction model performs better predicting 5year risk copd ehscopd study based 135822 participants aged 65 years hong kongs elderly health service ehs cohort assessed performance existing risk prediction model entire cohort random subsample 91133 participants recalibrated existing model derived new model using extended cox proportional hazards regression candidate risk predictors literature ehs cohort considered inclusion risk prediction performance discrimination calibration newly derived models assessed remaining 44689 participants existing risk prediction model overestimated 5year risk copd older chinese adults 65 years recalibration still overestimated 5year risk copd men women new ehscopd risk prediction model including timevarying factors ie age smoking status timeinvariant factors ie education level public assistance alcohol use body mass index physical activity existing hypertension recent falls cognitive function selfrated health status improved performance men ehscopd explained 195 copd risk statistic 231 harrells c statistic 093 corresponding values women 85 211 093 existing copd risk prediction model overpredicted copd risk older chinese could recalibrated predict well revised prediction model using timeinvariant timevarying factors provides better tool identifying older chinese adults high risk developing copd