A model for predicting death in adult patients within 10 years

Introduction . The identification of risk factors and the prediction of mortality from various causes are important issues in medicine. From a preventive perspective, it is crucial to identify patients at high risk of death, as early detection and treatment of diseases effectively increase life expectancy. The purpose of the study : to develop a universal model for predicting death in adult patients within 10 years and to compare the predictive ability of predicting death in a large contemporary cohort of the machine learning model (decision trees) with a Cox regression. Materials and methods . The data source for the study was the database of the Webiomed predictive analytics platform. The study included 1,129,268 records of 201,985 patients aged 18 years and older. 177 predictive features were investigated, of which 12 were selected for modelling as a result of a multi-stage selection process. Two survival analysis algorithms, CoxPHFitter and RandomSurvivalForest, were used for modelling. The models were used to determine the probability of death within 1, 3, 5 and 10 years. Results . Both models performed well in predicting death, however, the best result was obtained by the RSF model. Metrics of the best model with 95% CI for predicting death within 10 years: AUC0.921 (0.914–0.929), Accuracy 0.849 (0.84–0.858), Sensitivity 0.813 (0.795–0.83), Specificity 0.871 (0.859–0.882), Concordance index 0.867 (0.861–0.874), Positive predictive value 0.791 (0.776–0.806), Negative Predictive Value 0.886 (0.876–0.895). Conclusion. Machine learning models predict mortality outcomes well, demonstrating high discrimination and classification accuracy. Their use may help to identify high-risk patients to inform decisions to prevent death.