Evidence map›Paper›PMID 33125706›Full record

ArticleHealth services research2020

Predicting preventable hospital readmissions with causal machine learning.

Ben J Marafino, Alejandro Schuler, Vincent X Liu, Gabriel J Escobar, Mike Baiocchi

Erratum issuedAbstract read
In one paragraph

Article in Health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

  1. Trial
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  9. Clinical Applications of Machine Learning.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024
    Review
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  11. Article
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  13. Observational
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Ben J MarafinoBiomedical Informatics Training Program, Department of Biomedical Data Science, School of Medicine, Stanford University, Stanford, California, USA.ORCID 0000-0003-2385-7376
Alejandro SchulerSystems Research Initiative, Kaiser Permanente Division of Research, Oakland, California, USA.ORCID 0000-0003-4853-6130
Vincent X LiuSystems Research Initiative, Kaiser Permanente Division of Research, Oakland, California, USA.ORCID 0000-0001-6899-9998
Gabriel J EscobarSystems Research Initiative, Kaiser Permanente Division of Research, Oakland, California, USA.ORCID 0000-0003-2540-3327
Mike BaiocchiDepartments of Epidemiology & Population Health, Department of Medicine, Stanford University, Stanford, California, USA.ORCID 0000-0002-7571-5268

Funding

POSTDOCTORAL TRAINING IN MEDICAL INFORMATION SCIENCEST15LM007033 · NLM · STANFORD UNIVERSITY · PI SYLVIA KATINA PLEVRITIS · 1985 to 2026
$25.5M
Identifying pre-sepsis opportunities for early, targeted intervention - Equipment SupplementR35GM128672 · NIGMS · KAISER FOUNDATION RESEARCH INSTITUTE · PI Vincent Liu · 2018 to 2026
$4.3M
Cancer Systems Biology Scholars ProgramR25CA180993 · NCI · STANFORD UNIVERSITY · PI PLEVRITIS, SYLVIA KATINA · 2014 to 2018
$2.2M
The development of statistical tools for comparative effectiveness researchR00HS022192 · AHRQ · STANFORD UNIVERSITY · PI BAIOCCHI, MIKE · 2014 to 2016
$747k
The development of statistical tools for comparative effectiveness researchK99HS022192 · AHRQ · STANFORD UNIVERSITY · PI BAIOCCHI, MIKE · 2013 to 2013
$106k
AHRQ HHS K99 HS022192AHRQ HHS R00 HS022192NCI NIH HHS R25 CA180993NIGMS NIH HHS R35 GM128672NLM NIH HHS T15 LM007033
6 · The paper itself

Abstract

objectiveTo assess both the feasibility and potential impact of predicting preventable hospital readmissions using causal machine learning applied to data from the implementation of a readmissions prevention intervention (the Transitions Program). DATA SOURCES: Electronic health records maintained by Kaiser Permanente Northern California (KPNC). STUDY

designRetrospective causal forest analysis of postdischarge outcomes among KPNC inpatients. Using data from both before and after implementation, we apply causal forests to estimate individual-level treatment effects of the Transitions Program intervention on 30-day readmission. These estimates are used to characterize treatment effect heterogeneity and to assess the notional impacts of alternative targeting strategies in terms of the number of readmissions prevented. DATA COLLECTION: 1 539 285 index hospitalizations meeting the inclusion criteria and occurring between June 2010 and December 2018 at 21 KPNC hospitals. PRINCIPAL

findingsThere appears to be substantial heterogeneity in patients' responses to the intervention (omnibus test for heterogeneity p = 2.23 × 10

conclusionsCausal machine learning can be used to identify preventable hospital readmissions, if the requisite interventional data are available. Moreover, our results suggest a mismatch between risk and treatment effects.

Indexed as

AgedAge FactorsContinuity of Patient CareDiagnostic Techniques and ProceduresElectronic Health RecordsFemaleHealth Services ResearchHealth StatusHumansMachine LearningMaleMiddle AgedPatient ReadmissionRetrospective StudiesRisk AssessmentRisk Factorsclinical decision rulesmachine learningpatient readmissionrisk assessment

Identifiers

PMID33125706
PMCPMC7704477

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.