ArticleChest2023
Refining the Lung Allocation Score Models Fails to Improve Discrimination Performance.
Article in Chest, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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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.
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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.
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Who cites it
16 citing papers in PubMed.
- Artificial intelligence and machine learning in heart and lung transplantation.EClinicalMedicine · 2026Review
- XGBoost Outperforms Traditional Transplant Regulatory Models Based on Regression.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Influence of U.S. lung composite allocation score components on transplant candidate prioritization.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2026Article
- Transforming lung transplantation with artificial intelligence: a narrative review from organ allocation to post-transplant management.Journal of thoracic disease · 2026Review
- National Organ Procurement and Transplant Network Heart Allocation Policy: 6 Years Later.Circulation. Heart failure · 2025Review
- Article
- Development of a Machine Learning-Powered Optimized Lung Allocation System for Maximum Benefits in Lung Transplantation: A Korean National Data.Journal of Korean medical science · 2025Article
- Understanding Machine Learning Applications in Lung Transplantation: A Narrative Review.Transplant international : official journal of the European Society for Organ Transplantation · 2025Review
- Application of artificial intelligence and machine learning in lung transplantation: a comprehensive review.Frontiers in digital health · 2025Review
- Scoring donor lungs for graft failure risk: The Lung Donor Risk Index (LDRI).American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024Article
- A Hospitable Home? Cell-Free DNA and the Inflammatory Milieu in Lung Transplant Candidates.American journal of respiratory and critical care medicine · 2024Article
- Cell-Free DNA Maps Tissue Injury and Correlates with Disease Severity in Lung Transplant Candidates.American journal of respiratory and critical care medicine · 2024Article
- Lung Allocation Score Exceptions in Persons with Cystic Fibrosis Undergoing Lung Transplant.Annals of the American Thoracic Society · 2024Article
- A new method for classifying prognostic risk factors in lung transplant candidates.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2023Article
- Transplanting candidates with stacked risks negatively affects outcomes.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2023Article
- Miscalibration of lung allocation models leads to inaccurate waitlist mortality predictions.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2023Article
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5 authors.
Funding
Abstract
backgroundAs broader geographic sharing is implemented in lung transplant allocation through the Composite Allocation Score (CAS) system, models predicting waitlist and posttransplant (PT) survival will become more important in determining access to organs. RESEARCH QUESTION: How well do CAS survival models perform, and can discrimination performance be improved with alternative statistical models or machine learning approaches? STUDY DESIGN AND
methodsScientific Registry for Transplant Recipients (SRTR) data from 2015-2020 were used to build seven waitlist (WL) and data from 2010-2020 to build similar PT models. These included the (I) current lung allocation score (LAS)/CAS model; (II) re-estimated WL-LAS/CAS model; (III) model II incorporating nonlinear relationships; (IV) random survival forests model; (V) logistic model; (VI) linear discriminant analysis; and (VII) gradient-boosted tree model. Discrimination performance was evaluated at 1, 3, and 6 months on the waiting list and 1, 3, and 5 years PT. Area under the curve (AUC) values were estimated across subgroups.
resultsWL model performance was similar across models with the greatest discrimination in the baseline cohort (AUC 0.93) and declined to 0.87-0.89 for 3-month and 0.84-0.85 for 6-month predictions and further diminished for residual cohorts. Discrimination performance for PT models ranged from AUC 0.58-0.61 and remained stable with increasing forecasting times but was slightly worse for residual cohorts. WL and PT variability in AUC was greatest for individuals with Medicaid insurance.
interpretationUse of alternative modeling strategies and contemporary cohorts did not improve performance of models determining access to lung transplant.
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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.