Development and external validation of the NEO-READY model to predict date of discharge among premature neonatal intensive care patients
Lonsdale, H.; Patel, K. B.; Domenico, H.; Moore, R. S.; McCoy, A. B.; French, B.; Rosenbloom, S. T.; Byrne, D. W.; Freundlich, R. E.; Alrifai, M. W.
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OBJECTIVETo develop a parsimonious, interpretable, and accurate model for predicting discharge for premature infants in the NICU that is suitable for prospective evaluation and integration into clinical workflows. STUDY DESIGNUsing routinely available electronic health record data, we developed and validated NEOnatal Reliable Estimation of Approaching Discharge in Young infants (NEO-READY), a daily-updating model that predicts likelihood of discharge within 5 days for premature infants. RESULTSData from 702 infants were used to develop the model, and data from 201 infants were used for temporal external validation. The model includes 13 predictors and two interaction terms and demonstrated excellent discrimination across development (AUC = 0.88, 95% CI 0.87-0.90) and validation (0.90, 0.88-0.91) cohorts. CONCLUSIONThis work represents step 1 toward our long-term goal: integrating the NEO-READY model into clinical workflows as part of a comprehensive strategy to improve discharge preparedness, reduce discharge delays, and optimize NICU resources.
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