A comparison of risk prediction methods using repeated observations: an application to electronic health records for hemodialysis. (2nd May 2017)

• Record Type: Journal Article
• Authors: Goldstein, Benjamin A.; Pomann, Gina Maria; Winkelmayer, Wolfgang C.; Pencina, Michael J.
• Is Part Of: Statistics in medicine. Volume 36:Number 17(2017)
• Page Start: 2750
• Page End: 2763
• Publication Date: 2017-05-02
• Subjects: electronic health records -- clinical risk prediction -- longitudinal data -- functional data analysis -- joint models -- hemodialysis -- end‐stage renal disease; Medical statistics -- Periodicals; Statistique médicale -- Périodiques; Statistiques médicales -- Périodiques; 610.727
• DOI: 10.1002/sim.7308
• Languages: English
• ISSNs: 0277-6715

Abstract

Abstract : An increasingly important data source for the development of clinical risk prediction models is electronic health records (EHRs). One of their key advantages is that they contain data on many individuals collected over time. This allows one to incorporate more clinical information into a risk model. However, traditional methods for developing risk models are not well suited to these irregularly collected clinical covariates. In this paper, we compare a range of approaches for using longitudinal predictors in a clinical risk model. Using data from an EHR for patients undergoing hemodialysis, we incorporate five different clinical predictors into a risk model for patient mortality. We consider different approaches for treating the repeated measurements including use of summary statistics, machine learning methods, functional data analysis, and joint models. We follow up our empirical findings with a simulation study. Overall, our results suggest that simple approaches perform just as well, if not better, than more complex analytic approaches. These results have important implication for development of risk prediction models with EHRs. Copyright © 2017 John Wiley & Sons, Ltd.