Evidence map›Paper›PMID 28263938›Full record

SynthesisCirculation. Cardiovascular quality and outcomes2016

Analysis of Machine Learning Techniques for Heart Failure Readmissions.

Bobak J Mortazavi, Nicholas S Downing, Emily M Bucholz, Kumar Dharmarajan, Ajay Manhapra, Shu-Xia Li, Sahand N Negahban, Harlan M Krumholz

Registry-linked trialAbstract readComparative StudyMeta-Analysis
In one paragraph

Synthesis in Circulation. Cardiovascular quality and outcomes, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03804606 (Risk and Benefit Informed MTM Pharmacist Intervention in Heart Failure), which is not on this map. Cited by 175 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
175citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03804606 naterminatednot on this mapstarted 2019, after this paper: background citation

Risk and Benefit Informed MTM Pharmacist Intervention in Heart Failure

TypeinterventionalSponsorGeisinger ClinicRan2019 to 2023Enrolled100ConditionsHeart FailureArmsReferral to MTM Pharmacist
3 · Its place in the literature

Who cites it

175 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
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  5. Guideline
  6. Pooled it
  7. Longitudinal trajectories of hospitalizations in US older adults with heart failure.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026
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  13. Observational
  14. Review
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  17. Artificial intelligence in heart failure.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2026
    Review
  18. Article
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  20. Article

115 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Bobak J MortazaviFrom the Section of Cardiovascular Medicine, Department of Internal Medicine (B.J.M., N.S.D., E.M.B., K.D., H.M.K.), Department of Psychiatry and the Section of General Medicine, Department of Internal Medicine (A.M.), and Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (B.J.M., N.S.D., E.M.B., K.D., S.-X.L., H.M.K.); and Department of Statistics, Yale University, New Haven, CT (B.J.M., S.N.N.).
Nicholas S DowningFrom the Section of Cardiovascular Medicine, Department of Internal Medicine (B.J.M., N.S.D., E.M.B., K.D., H.M.K.), Department of Psychiatry and the Section of General Medicine, Department of Internal Medicine (A.M.), and Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (B.J.M., N.S.D., E.M.B., K.D., S.-X.L., H.M.K.); and Department of Statistics, Yale University, New Haven, CT (B.J.M., S.N.N.).
Emily M BucholzFrom the Section of Cardiovascular Medicine, Department of Internal Medicine (B.J.M., N.S.D., E.M.B., K.D., H.M.K.), Department of Psychiatry and the Section of General Medicine, Department of Internal Medicine (A.M.), and Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (B.J.M., N.S.D., E.M.B., K.D., S.-X.L., H.M.K.); and Department of Statistics, Yale University, New Haven, CT (B.J.M., S.N.N.).
Kumar DharmarajanFrom the Section of Cardiovascular Medicine, Department of Internal Medicine (B.J.M., N.S.D., E.M.B., K.D., H.M.K.), Department of Psychiatry and the Section of General Medicine, Department of Internal Medicine (A.M.), and Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (B.J.M., N.S.D., E.M.B., K.D., S.-X.L., H.M.K.); and Department of Statistics, Yale University, New Haven, CT (B.J.M., S.N.N.).
Ajay ManhapraFrom the Section of Cardiovascular Medicine, Department of Internal Medicine (B.J.M., N.S.D., E.M.B., K.D., H.M.K.), Department of Psychiatry and the Section of General Medicine, Department of Internal Medicine (A.M.), and Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (B.J.M., N.S.D., E.M.B., K.D., S.-X.L., H.M.K.); and Department of Statistics, Yale University, New Haven, CT (B.J.M., S.N.N.).
Shu-Xia LiFrom the Section of Cardiovascular Medicine, Department of Internal Medicine (B.J.M., N.S.D., E.M.B., K.D., H.M.K.), Department of Psychiatry and the Section of General Medicine, Department of Internal Medicine (A.M.), and Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (B.J.M., N.S.D., E.M.B., K.D., S.-X.L., H.M.K.); and Department of Statistics, Yale University, New Haven, CT (B.J.M., S.N.N.).
Sahand N NegahbanFrom the Section of Cardiovascular Medicine, Department of Internal Medicine (B.J.M., N.S.D., E.M.B., K.D., H.M.K.), Department of Psychiatry and the Section of General Medicine, Department of Internal Medicine (A.M.), and Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (B.J.M., N.S.D., E.M.B., K.D., S.-X.L., H.M.K.); and Department of Statistics, Yale University, New Haven, CT (B.J.M., S.N.N.).
Harlan M KrumholzFrom the Section of Cardiovascular Medicine, Department of Internal Medicine (B.J.M., N.S.D., E.M.B., K.D., H.M.K.), Department of Psychiatry and the Section of General Medicine, Department of Internal Medicine (A.M.), and Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (B.J.M., N.S.D., E.M.B., K.D., S.-X.L., H.M.K.); and Department of Statistics, Yale University, New Haven, CT (B.J.M., S.N.N.). harlan.krumholz@yale.edu.

Funding

Telemonitoring to improve heart failure outcomesR01HL080228 · NHLBI · YALE UNIVERSITY · PI KRUMHOLZ, HARLAN MARC · 2005 to 2008
$6.9M
Center for Cardiovascular Outcomes Research at Yale UniversityU01HL105270 · NHLBI · YALE UNIVERSITY · PI CURTIS, JEPTHA PELHAM, KRUMHOLZ, HARLAN MARC · 2010 to 2013
$5.8M
Advancing Clinical Research Training within Addiction Residency ProgramsR25DA033211 · NIDA · BOSTON MEDICAL CENTER · PI Patrick O'Connor, JEFFREY H. SAMET · 2012 to 2026
$4.2M
Geriatric Conditions and Readmission after Acute Myocardial InfarctionK23AG048331 · NIA · YALE UNIVERSITY · PI DHARMARAJAN, KUMAR · 2014 to 2017
$692k
NHLBI NIH HHS R01 HL080228NHLBI NIH HHS U01 HL105270NIA NIH HHS K23 AG048331NIDA NIH HHS R25 DA033211
6 · The paper itself

Abstract

backgroundThe current ability to predict readmissions in patients with heart failure is modest at best. It is unclear whether machine learning techniques that address higher dimensional, nonlinear relationships among variables would enhance prediction. We sought to compare the effectiveness of several machine learning algorithms for predicting readmissions. METHODS AND

resultsUsing data from the Telemonitoring to Improve Heart Failure Outcomes trial, we compared the effectiveness of random forests, boosting, random forests combined hierarchically with support vector machines or logistic regression (LR), and Poisson regression against traditional LR to predict 30- and 180-day all-cause readmissions and readmissions because of heart failure. We randomly selected 50% of patients for a derivation set, and a validation set comprised the remaining patients, validated using 100 bootstrapped iterations. We compared C statistics for discrimination and distributions of observed outcomes in risk deciles for predictive range. In 30-day all-cause readmission prediction, the best performing machine learning model, random forests, provided a 17.8% improvement over LR (mean C statistics, 0.628 and 0.533, respectively). For readmissions because of heart failure, boosting improved the C statistic by 24.9% over LR (mean C statistic 0.678 and 0.543, respectively). For 30-day all-cause readmission, the observed readmission rates in the lowest and highest deciles of predicted risk with random forests (7.8% and 26.2%, respectively) showed a much wider separation than LR (14.2% and 16.4%, respectively).

conclusionsMachine learning methods improved the prediction of readmission after hospitalization for heart failure compared with LR and provided the greatest predictive range in observed readmission rates.

Indexed as

AlgorithmsPatient ReadmissionSupport Vector MachineTelemedicineAgedDatabases, FactualData MiningFemaleHeart FailureHumansLogistic ModelsMaleMiddle AgedNonlinear DynamicsRandomized Controlled Trials as TopicReproducibility of Resultscomputersheart failuremachine learningmeta-analysispatient readmission

Identifiers

PMID28263938
PMCPMC5459389

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.