Evidence map›Paper›PMID 31888507›Full record

Observational studyBMC medical research methodology2019

Clinical risk prediction with random forests for survival, longitudinal, and multivariate (RF-SLAM) data analysis.

Shannon Wongvibulsin, Katherine C Wu, Scott L Zeger

Registry-linked trialAbstract readObservational Study
In one paragraph

Observational study in BMC medical research methodology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01076660 (Left Ventricular Structural Predictors of Sudden Cardiac Death [Substudy of), which is not on this map. Cited by 43 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 3 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.

NCT01076660 recruitingnot on this map

Left Ventricular Structural Predictors of Sudden Cardiac Death [Substudy of: Functional Energetics and Imaging for Phenotypic Characterization of Patients at Risk for Sudden Cardiac Death, See Also NCT000181233]

TypeobservationalSponsorJohns Hopkins UniversityRan2003 to 2030Enrolled400ConditionsIschemic Cardiomyopathy, Nonischemic Cardiomyopathy
3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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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

3 authors.

Shannon WongvibulsinDepartment of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, USA. swongvi1@jhmi.edu.
Katherine C WuDepartment of Medicine, Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, USA.
Scott L ZegerDepartment of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007309 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI COX, ANDREA L · 1985 to 2019
$43.2M
Cardiac MR to Improve Clinical Risk Prediction in Defibrilator PatientsR01HL132181 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI TOMASELLI, GORDON FRANK, WU, KATHERINE C · 2017 to 2020
$3.1M
LV Structural Predictors of Sudden Cardiac DeathR01HL103812 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI WU, KATHERINE C · 2010 to 2013
$1.4M
Sudden Cardiac Arrest (SCA): Prediction and PreventionF30HL142131 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI WONGVIBULSIN, SHANNON · 2018 to 2020
$135k
NHLBI NIH HHS F30 HL142131NHLBI NIH HHS R01 HL103812NHLBI NIH HHS R01 HL132181NIGMS NIH HHS T32 GM007309
6 · The paper itself

Abstract

backgroundClinical research and medical practice can be advanced through the prediction of an individual's health state, trajectory, and responses to treatments. However, the majority of current clinical risk prediction models are based on regression approaches or machine learning algorithms that are static, rather than dynamic. To benefit from the increasing emergence of large, heterogeneous data sets, such as electronic health records (EHRs), novel tools to support improved clinical decision making through methods for individual-level risk prediction that can handle multiple variables, their interactions, and time-varying values are necessary.

methodsWe introduce a novel dynamic approach to clinical risk prediction for survival, longitudinal, and multivariate (SLAM) outcomes, called random forest for SLAM data analysis (RF-SLAM). RF-SLAM is a continuous-time, random forest method for survival analysis that combines the strengths of existing statistical and machine learning methods to produce individualized Bayes estimates of piecewise-constant hazard rates. We also present a method-agnostic approach for time-varying evaluation of model performance.

resultsWe derive and illustrate the method by predicting sudden cardiac arrest (SCA) in the Left Ventricular Structural (LV) Predictors of Sudden Cardiac Death (SCD) Registry. We demonstrate superior performance relative to standard random forest methods for survival data. We illustrate the importance of the number of preceding heart failure hospitalizations as a time-dependent predictor in SCA risk assessment.

conclusionsRF-SLAM is a novel statistical and machine learning method that improves risk prediction by incorporating time-varying information and accommodating a large number of predictors, their interactions, and missing values. RF-SLAM is designed to easily extend to simultaneous predictions of multiple, possibly competing, events and/or repeated measurements of discrete or continuous variables over time.

trial registrationLV Structural Predictors of SCD Registry (clinicaltrials.gov, NCT01076660), retrospectively registered 25 February 2010.

Indexed as

Bayes TheoremClinical Decision-MakingData AnalysisDeath, Sudden, CardiacElectronic Health RecordsForecastingHealth StatusHeart VentriclesHumansMachine LearningMultivariate AnalysisPrognosisRiskRisk AssessmentSurvival AnalysisClinical risk predictionDynamic risk predictionRandom forestsSurvival analysis

Identifiers

PMID31888507
PMCPMC6937754

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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.