Beyond Gut Feel: Predicting Outcomes of Digital Health Companies

Predicting which digital health companies will succeed is challenging because these firms operate at the intersection of rapid software innovation and slow, regulation- and reimbursement-driven healthcare adoption. We developed a machine learning model, enhanced with large language model (LLM)-derived features from unstructured text, to predict digital health company outcomes and benchmarked it against expert investors. Using data on 10,245 companies founded since 2000 and observed through March 2025, we trained logistic regression, random forest, and XGBoost models, plus an ensemble, to predict successful exits. The ensemble achieved the best discrimination (AUC = 0.934 ± 0.017) and balanced performance (macro-F1 = 0.775 ± 0.031). Adding LLM-derived features improved AUC by 0.007 (P < 0.05). In a blinded benchmark, model accuracy (63%) exceeded mean investor accuracy (52%) and matched the top investor (62%). These results highlight the potential of hybrid human–AI approaches to enhance objectivity and efficiency in digital health investment decisions.

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Publication Details

Journal
Repository for Publications and Research Data (ETH Zurich)
Published
2026-04-06
DOI
https://doi.org/10.3929/ethz-c-000798862
Primary Topic
Artificial Intelligence in Healthcare and Education
Type
article
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article

Beyond Gut Feel: Predicting Outcomes of Digital Health Companies

Estelle Pfitzer, Christoph Kausch, Tobias Kowatsch
Repository for Publications and Research Data (ETH Zurich)
Artificial Intelligence in Healthcare and Education
article

Beyond Gut Feel: Predicting Outcomes of Digital Health Companies

Estelle Pfitzer, Christoph Kausch, Tobias Kowatsch
article en

Abstract

Predicting which digital health companies will succeed is challenging because these firms operate at the intersection of rapid software innovation and slow, regulation- and reimbursement-driven healthcare adoption. We developed a machine learning model, enhanced with large language model (LLM)-derived features from unstructured text, to predict digital health company outcomes and benchmarked it against expert investors. Using data on 10,245 companies founded since 2000 and observed through March 2025, we trained logistic regression, random forest, and XGBoost models, plus an ensemble, to predict successful exits. The ensemble achieved the best discrimination (AUC = 0.934 ± 0.017) and balanced performance (macro-F1 = 0.775 ± 0.031). Adding LLM-derived features improved AUC by 0.007 (P < 0.05). In a blinded benchmark, model accuracy (63%) exceeded mean investor accuracy (52%) and matched the top investor (62%). These results highlight the potential of hybrid human–AI approaches to enhance objectivity and efficiency in digital health investment decisions.

Repository for Publications and Research Data (ETH Zurich)
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Artificial Intelligence in Healthcare and Education
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Beyond Gut Feel: Predicting Outcomes of Digital Health Companies — Estelle Pfitzer, Christoph Kausch, et al. · Repository for Publications and Research Data (ETH Zurich) (2026) | TGRS Research Map | TGRS