Evidence map›Paper›PMID 40721333›Full record

ArticleAnnals of family medicine2025

Predicting Missed Appointments in Primary Care: A Personalized Machine Learning Approach.

Wen-Jan Tuan, Yifang Yan, Bilal Abou Al Ardat, Todd Felix, Qiushi Chen

Abstract read
In one paragraph

Article in Annals of family medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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

5 authors.

Wen-Jan TuanDepartment of Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania wtuan@pennstatehealth.psu.edu.
Yifang YanHarold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, Pennsylvania.
Bilal Abou Al ArdatDepartment of Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania.
Todd FelixDepartment of Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania.
Qiushi ChenHarold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, Pennsylvania.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFactors influencing missed appointments are complex and difficult to anticipate and intervene against. To optimize appointment adherence, we aimed to use personalized machine learning and big data analytics to predict the risk of and contributing factors for no-shows and late cancellations in primary care practices.

methodsWe conducted a retrospective longitudinal study leveraging geolinked clinical, care utilization, socioeconomic, and climate data from 15 family medicine clinics at a regional academic health center in Pennsylvania from January 2019 to June 2023. We developed multiclass machine learning models using gradient boost, random forest, neural network, and logistic regression to predict appointment outcomes, followed by feature importance analysis to identify contributing factors for no-shows or late cancellations at the population and patient levels. We performed stratified analysis to evaluate the prediction performance by sex and race/ethnicity to ensure the fairness of the final model among sensitive features.

resultsThe analysis consisted of 109,328 patients and 1,118,236 appointments, including 77,322 (6.9%) no-shows and 75,545 (6.8%) late cancellations. The gradient boost model achieved the best performance with an area under the receiver operating characteristic curve of 0.852 for predicting no-shows and 0.921 for late cancellations. No bias against patient characteristics was detected. Schedule lead time was identified as the most important predictor of missed appointments.

conclusionsMissed appointments remain a challenge for primary care. This study provided a practical and robust framework to predict missed appointments, laying the foundation for developing personalized strategies to improve patients' adherence to primary care appointments.

Indexed as

Appointments and SchedulesMachine LearningNo-Show PatientsPrimary Health CareAdultAgedFemaleHumansLogistic ModelsLongitudinal StudiesMaleMiddle AgedPennsylvaniaRetrospective Studiescontinuity of carehealth disparitylate cancellationmachine learningno-show

Identifiers

PMID40721333
PMCPMC12306982

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Registered trials

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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.