Validity of an artificial neural network in predicting discharge destination from a postacute geriatric rehabilitation unit.
OBJECTIVE
To develop an artificial neural network (ANN) designed to predict discharge destination from postacute geriatric rehabilitation units.


METHODS
Nonconcurrent prospective study.


METHODS
Postacute geriatric rehabilitation units: a 20-bed unit in a nonproprietary skilled nursing facility and a 40-bed unit in a suburban private facility.


METHODS
Consecutive sample of 661 patients admitted between January 1995 and February 1999, including a derivation group of 452 patients and a validation group of 209 patients.


METHODS
A feed-forward, back-propagation neural network to predict discharge destination.


METHODS
Discharge destination from postacute geriatric rehabilitation.


RESULTS
An ANN was trained on clinical pattern set derived from 452 patients and validated prospectively on 209 consecutive patients admitted to postacute geriatric rehabilitation units. The neural network achieved a sensitivity of 85.7% (95% confidence interval [CI], 83.7-89.4) and specificity of 94.1% (95% CI, 84.4-99.1) in identifying discharge destination with a corresponding area under the curve of 95.7% (95% CI, 92.1-98.3).


CONCLUSIONS
An ANN can predict discharge to the community postacute rehabilitation with a high degree of accuracy. It could have particular value to predict return to the community for older adults with multiple comorbidities after an acute hospitalization.
El-Solh
A A
AA
Department of Medicine, Erie County Medical Center, Buffalo, NY 14215, USA. solh@buffalo.edu
Saltzman
S K
SK
Ramadan
F H
FH
Naughton
B J
BJ
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002641:Chicago; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D016571:Neural Networks, Computer; D009735:Nursing Homes; D010351:Patient Discharge; D011379:Prognosis; D011446:Prospective Studies; D012046:Rehabilitation / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012944:Social Support; D014481:United States