Dataset Information

Using elastic nets to estimate frailty burden from routinely collected national aged care data.

ABSTRACT:

Objectives

To (1) use an elastic net (EN) algorithm to derive a frailty measure from a national aged care eligibility assessment program; (2) compare the ability of EN-based and a traditional cumulative deficit (CD) based frailty measures to predict mortality and entry into permanent residential care; (3) assess if the predictive ability can be improved by using weighted frailty measures.

Materials and methods

A Cox proportional hazard model based EN algorithm was applied to the 2003-2013 cohort of 903 996 participants for selecting items to enter an EN based frailty measure. The out-of-sample predictive accuracy was measured by the area under the curve (AUC) from Cox models fitted to 80% training and validated on 20% testing samples.

Results

The EN approach resulted in a 178-item frailty measure including items excluded from the 44-item CD-based measure. The EN based measure was not statistically significantly different from the CD-based approach in terms of predicting mortality (AUC 0.641, 95% CI: 0.637-0.644 vs AUC 0.637, 95% CI: 0.634-0.641) and permanent care entry (AUC 0.626, 95% CI: 0.624-0.629 vs AUC 0.627, 95% CI: 0.625-0.63). However, the weighted EN based measure statistically outperforms the weighted CD measure for predicting mortality (AUC 0.774, 95% CI: 0.771-0.777 vs AUC 0.757, 95% CI: 0.754-0.760) and permanent care entry (AUC 0.676, 95% CI: 0.673-0.678 vs AUC 0.671, 95% CI: 0.668-0.674).

Conclusions

The weighted EN and CD-based measures demonstrated similar prediction performance. The CD-based measure items are relevant to frailty measurement and easier to interpret. We recommend using the weighted and unweighted CD-based frailty measures.

SUBMITTER: Moldovan M

PROVIDER: S-EPMC7647260 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Using elastic nets to estimate frailty burden from routinely collected national aged care data.

Moldovan Max M Khadka Jyoti J Visvanathan Renuka R Wesselingh Steve S Inacio Maria C MC

Journal of the American Medical Informatics Association : JAMIA 20200301 3

<h4>Objectives</h4>To (1) use an elastic net (EN) algorithm to derive a frailty measure from a national aged care eligibility assessment program; (2) compare the ability of EN-based and a traditional cumulative deficit (CD) based frailty measures to predict mortality and entry into permanent residential care; (3) assess if the predictive ability can be improved by using weighted frailty measures.<h4>Materials and methods</h4>A Cox proportional hazard model based EN algorithm was applied to the 2 ...[more]

PMID: 31951002

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Dataset Information

Using elastic nets to estimate frailty burden from routinely collected national aged care data.

Objectives

Materials and methods

Results

Conclusions

Publications

Using elastic nets to estimate frailty burden from routinely collected national aged care data.

Similar Datasets

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