ArticleJournal of Brown hospital medicine2024
Quality Improvement Study Using a Machine Learning Mortality Risk Prediction Model Notification System on Advance Care Planning in High-Risk Patients.
Article in Journal of Brown hospital medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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.
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Who cites it
1 citing paper in PubMed.
- Impact of Prognostic Notifications on Inpatient Advance Care Planning: A Cluster Randomized Trial.Journal of pain and symptom management · 2025Trial
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Authors and funding
9 authors.
Funding
Abstract
backgroundAdvance care planning (ACP) is an important aspect of patient care that is underutilized. Machine learning (ML) models can help identify patients appropriate for ACP. The objective was to evaluate the impact of using provider notifications based on an ML model on the rate of ACP documentation and patient outcomes.
methodsThis was a pre-post QI intervention study at a tertiary academic hospital. Adult patients admitted to general medicine teams identified to be at elevated risk of mortality using an ML model were included in the study. The intervention consisted of notifying a provider by email and page for a patient identified by the ML model.
resultsA total of 479 encounters were analyzed of which 282 encounters occurred post-intervention. The covariate-adjusted proportion of higher-risk patients with documented ACP rose from 6.0% at baseline to 56.5% (Risk Ratio (RR)= 9.42, 95% CI: 4.90 - 18.11). Patients with ACP were more than twice as likely to have code status reduced when ACP was documented (29.0% vs. 10.8% RR=2.69, 95% CI: 1.64 - 4.27). Additionally, patients with ACP had twice the odds of hospice referral (22.2% vs. 12.6% Odds Ratio=2.16, 95% CI: 1.16 - 4.01). However, patients with ACP documented had a longer mean LOS (9.7 vs. 7.6 days, Event time ratio = 1.29, 95% CI: 1.10 - 1.53).
conclusionProvider notifications using an ML model can lead to an increase in completion of ACP documentation by frontline clinicians in the inpatient setting.
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