TY  - JOUR
AU  - Kim, Ji Woong
AU  - Ha, Juhyung
AU  - Kim, Taerim
AU  - Yoon, Hee
AU  - Hwang, Sung Yeon
AU  - Jo, Ik Joon
AU  - Shin, Tae Gun
AU  - Sim, Min Seob
AU  - Kim, Kyunga
AU  - Cha, Won Chul
PY  - 2021
DA  - 2021/7/5
TI  - Developing a Time-Adaptive Prediction Model for Out-of-Hospital Cardiac Arrest: Nationwide Cohort Study in Korea
JO  - J Med Internet Res
SP  - e28361
VL  - 23
IS  - 7
KW  - out-of-hospital cardiac arrest
KW  - Republic of Korea
KW  - machine learning
KW  - artificial intelligence
KW  - prognosis
KW  - cardiology
KW  - prediction model
AB  - Background: Out-of-hospital cardiac arrest (OHCA) is a serious public health issue, and predicting the prognosis of OHCA patients can assist clinicians in making decisions about the treatment of patients, use of hospital resources, or termination of resuscitation. Objective: This study aimed to develop a time-adaptive conditional prediction model (TACOM) to predict clinical outcomes every minute. Methods: We performed a retrospective observational study using data from the Korea OHCA Registry in South Korea. In this study, we excluded patients with trauma, those who experienced return of spontaneous circulation before arriving in the emergency department (ED), and those who did not receive cardiopulmonary resuscitation (CPR) in the ED. We selected patients who received CPR in the ED. To develop the time-adaptive prediction model, we organized the training data set as ongoing CPR patients by the minute. A total of 49,669 patients were divided into 39,602 subjects for training and 10,067 subjects for validation. We compared random forest, LightGBM, and artificial neural networks as the prediction model methods. Model performance was quantified using the prediction probability of the model, area under the receiver operating characteristic curve (AUROC), and area under the precision recall curve. Results: Among the three algorithms, LightGBM showed the best performance. From 0 to 30 min, the AUROC of the TACOM for predicting good neurological outcomes ranged from 0.910 (95% CI 0.910-0.911) to 0.869 (95% CI 0.865-0.871), whereas that for survival to hospital discharge ranged from 0.800 (95% CI 0.797-0.800) to 0.734 (95% CI 0.736-0.740). The prediction probability of the TACOM showed similar flow with cohort data based on a comparison with the conventional model’s prediction probability. Conclusions: The TACOM predicted the clinical outcome of OHCA patients per minute. This model for predicting patient outcomes by the minute can assist clinicians in making rational decisions for OHCA patients. 
SN  - 1438-8871
UR  - https://www.jmir.org/2021/7/e28361/
UR  - https://doi.org/10.2196/28361
UR  - http://www.ncbi.nlm.nih.gov/pubmed/36260382
DO  - 10.2196/28361
ID  - info:doi/10.2196/28361
ER  -