# A scalable approach for developing clinical risk prediction applications in different hospitals

arXiv: https://arxiv.org/abs/2101.10268 · HTML: https://mlsanity.com/paper/2101.10268/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 6 of its 34 references that are in the map.
- First posted on arXiv 21 Jan 2021.

## Builds on (most cited first, 6 of 6)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- ["Why Should I Trust You?": Explaining the Predictions of Any Classifier](https://mlsanity.com/paper/1602.04938/) (2016)
- [Visualizing and Understanding Convolutional Networks](https://mlsanity.com/paper/1311.2901/) (2013)
- [A Multiscale Visualization of Attention in the Transformer Model](https://mlsanity.com/paper/1906.05714/) (2019)
- [Scalable and accurate deep learning for electronic health records](https://mlsanity.com/paper/1801.07860/) (2018)
- [Semantic processing of EHR data for clinical research](https://mlsanity.com/paper/1511.03036/) (2015)

## Built on by (most cited first, 1 of 1)

- [Multimodal data matters: language model pre-training over structured and unstructured electronic health records](https://mlsanity.com/paper/2201.10113/) (2022)

## Abstract (arXiv)

Objective: Machine learning algorithms are now widely used in predicting acute events for clinical applications. While most of such prediction applications are developed to predict the risk of a particular acute event at one hospital, few efforts have been made in extending the developed solutions to other events or to different hospitals. We provide a scalable solution to extend the process of clinical risk prediction model development of multiple diseases and their deployment in different Electronic Health Records (EHR) systems. Materials and Methods: We defined a generic process for clinical risk prediction model development. A calibration tool has been created to automate the model generation process. We applied the model calibration process at four hospitals, and generated risk prediction models for delirium, sepsis and acute kidney injury (AKI) respectively at each of these hospitals. Results: The delirium risk prediction models achieved area under the receiver-operating characteristic curve (AUROC) ranging from 0.82 to 0.95 over different stages of a hospital stay on the test datasets of the four hospitals. The sepsis models achieved AUROC ranging from 0.88 to 0.95, and the AKI models achieved AUROC ranging from 0.85 to 0.92. Discussion: The scalability discussed in this paper is based on building common data representations (syntactic interoperability) between EHRs stored in different hospitals. Semantic interoperability, a more challenging requirement that different EHRs share the same meaning of data, e.g. a same lab coding system, is not mandated with our approach. Conclusions: Our study describes a method to develop and deploy clinical risk prediction models in a scalable way. We demonstrate its feasibility by developing risk prediction models for three diseases across four hospitals.