{"about":{"site":"https://codewithpapers.app","non_affiliation":"Code with Papers and Syntology are not affiliated with, endorsed by, or sponsored by Papers with Code, Meta, or the pwc-archive mirror.","licence":"CC BY-SA 4.0","licence_url":"https://creativecommons.org/licenses/by-sa/4.0/legalcode","attribution":"https://codewithpapers.app/attribution","modified":"archive material modified by Syntology; see the attribution page"},"url":"/paper/towards-clinical-prediction-with-transparency","title":"Towards Clinical Prediction with Transparency: An Explainable AI Approach to Survival Modelling in Residential Aged Care","arxiv_id":"2312.00271","date":"2023-12-01","proceeding":null,"authors":["Teo Susnjak","Elise Griffin"],"abstract":"Background: Accurate survival time estimates aid end-of-life medical decision-making. Objectives: Develop an interpretable survival model for elderly residential aged care residents using advanced machine learning. Setting: A major Australasian residential aged care provider. Participants: Residents aged 65+ admitted for long-term care from July 2017 to August 2023. Sample size: 11,944 residents across 40 facilities. Predictors: Factors include age, gender, health status, co-morbidities, cognitive function, mood, nutrition, mobility, smoking, sleep, skin integrity, and continence. Outcome: Probability of survival post-admission, specifically calibrated for 6-month survival estimates. Statistical Analysis: Tested CoxPH, EN, RR, Lasso, GB, XGB, and RF models in 20 experiments with a 90/10 train/test split. Evaluated accuracy using C-index, Harrell's C-index, dynamic AUROC, IBS, and calibrated ROC. Chose XGB for its performance and calibrated it for 1, 3, 6, and 12-month predictions using Platt scaling. Employed SHAP values to analyze predictor impacts. Results: GB, XGB, and RF models showed the highest C-Index values (0.714, 0.712, 0.712). The optimal XGB model demonstrated a 6-month survival prediction AUROC of 0.746 (95% CI 0.744-0.749). Key mortality predictors include age, male gender, mobility, health status, pressure ulcer risk, and appetite. Conclusions: The study successfully applies machine learning to create a survival model for aged care, aligning with clinical insights on mortality risk factors and enhancing model interpretability and clinical utility through explainable AI.","url_abs":"https://arxiv.org/abs/2312.00271v3","url_pdf":"https://arxiv.org/pdf/2312.00271v3.pdf","source":{"archive":"pwc-archive (Hugging Face), CC BY-SA 4.0","snapshot":"2025-07-28","licence_url":"https://creativecommons.org/licenses/by-sa/4.0/legalcode","row_kind":"abstracts"},"code_links":[{"paper_slug":"towards-clinical-prediction-with-transparency","repo_url":"https://github.com/teosusnjak/survival-analysis-stage1","is_official":1,"mentioned_in_paper":1,"mentioned_in_github":0,"framework":"none","reach":null}],"tasks":[{"task_slug":"decision-making","task_name":"Decision Making"},{"task_slug":"nutrition","task_name":"Nutrition"},{"task_slug":"survival-prediction","task_name":"Survival Prediction"}],"methods":[{"method_slug":"shap","method_name":"SHAP"}],"datasets_introduced":[],"methods_introduced":[],"results":[],"syntology":{"syntology_url":null,"atlas_url":null,"mcp":null,"developers":"https://syntology.ai/developers"},"arxiv_metadata":null,"syntology_extracted_results":null}