A Validated, Real-Time Prediction Model for Favorable Outcomes in Hospitalized COVID-19 Patients

Narges Razavian, Vincent J. Major, Mukund Sudarshan, Jesse Burk-Rafel, Peter Stella, Hardev Randhawa, Seda Bilaloglu, Ji Chen, Vuthy Nguy, Walter Wang, Hao Zhang, Ilan Reinstein, David Kudlowitz, Cameron Zenger, Meng Cao, Ruina Zhang, Siddhant Dogra, Keerthi Harish, Brian Bosworth, Fritz Francois, Leora Horwitz, Rajesh Ranganath, Jonathan Austrian, Yindalon Aphinyanaphongs
October, 2020
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Abstract

The COVID-19 pandemic has challenged front-line clinical decision-making, leading to numerous published prognostic tools. However, few models have been prospectively validated and none report implementation in practice. Here, we use 3345 retrospective and 474 prospective hospitalizations to develop and validate a parsimonious model to identify patients with favorable outcomes within 96 h of a prediction, based on real-time lab values, vital signs, and oxygen support variables. In retrospective and prospective validation, the model achieves high average precision (88.6% 95% CI: [88.4–88.7] and 90.8% [90.8–90.8]) and discrimination (95.1% [95.1–95.2] and 86.8% [86.8–86.9]) respectively. We implemented and integrated the model into the EHR, achieving a positive predictive value of 93.3% with 41% sensitivity. Preliminary results suggest clinicians are adopting these scores into their clinical workflows.

Type
Journal article
Publication
npj Digital Medicine
Machine Learning COVID-19 Prospective Validation
Vincent J. Major
Vincent J. Major
Assistant Professor

Vincent J. Major, PhD is an Assistant Professor at NYU Grossman School of Medicine working on applied machine learning for healthcare using electronic health record (EHR) data.