Aa. El-solh et al., Validity of an artificial neural network in predicting discharge destination from a postacute geriatric rehabilitation unit, ARCH PHYS M, 81(10), 2000, pp. 1388-1393
Objective: To develop an artificial neural network (ANN) designed to predic
t discharge destination from postacute geriatric rehabilitation units.
Design: Nonconcurrent prospective study.
Setting: Postacute geriatric rehabilitation units: a 20-bed unit in a nonpr
oprietary skilled nursing facility and a 40-bed unit in a suburban private
facility.
Patients: Consecutive sample of 661 patients admitted between January 1995
and February 1999, including a derivation group of 452 patients and a valid
ation group of 209 patients.
Interventions: A feed-forward, back-propagation neural network to predict d
ischarge destination.
Main Outcome Measure: Discharge destination from postacute geriatric rehabi
litation.
Results: An ANN was trained on clinical pattern set derived from 452 patien
ts and validated prospectively on 209 consecutive patients admitted to post
acute geriatric rehabilitation units. The neural network achieved a sensiti
vity 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 corre
sponding area under the curve of 95.7% (95% CI, 92.1-98.3).
Conclusion: An ANN can predict discharge to the community postacute rehabil
itation with a high degree of accuracy. It could have particular value to p
redict return to the community for older adults with multiple comorbidities
after an acute hospitalization.