Table 2

Performance of predictive models for 28-day or 30-day unplanned hospital readmissions (UHRs)

ReferenceModel nameDiscrimination (ROC)Calibration (H&L)Threshold (%)Sensitivity (%)Specificity (%)PPV (%)NPV (%)
All-cause UHRs (14)
Escobar et al16ED 30Validation: 0.7390.40≥20
≥30
≥60
    
Discharge 30Validation: 0.7560.60
LACE (validation)Validation: 0.7290.40
Yu et al17Institution-specific prediction model0.74 (hospital 2)
0.64 (at admission)
0.72 (after discharge)
      
LACE (validation)0.55 (hospital 2)
Baillie et al18Prediction modelRetrospective: 0.62  40853189
Prospective: 0.6139843089
Choudhry et al12ACC Admission ModelDerivation data set: 0.76
Internal validation: 0.75
Average (500 simulations in derivation data set): 0.76
External validation data set with recalibration: 0.76
Derivation data set: 36.0 (p<0.001)
Internal validation data set: 23.5 (p=0.0027)
External validation with recalibration: 6.1 (p=0.641)
117071
ACC Discharge ModelDerivation data set: 0.78
Internal validation: 0.77
Average: 0.78
External validation data set with recalibration: 0.78
Derivation: 31.1 (p<0.001)
Internal validation: 19.9 (p=0.01)
External validation with recalibration: 14.3 (p=0.074)
117071
Gildersleeve and Cooper19Risk of readmission score (RRS)Derivation cohort: 0.7421.6 (p=0.006)1474.954.422.292.6
Validation cohort: 0.7079.255.422.694.2
Kruse et al20UnnamedDerivation set: 0.668
Validation set: 0.657
Richmond21Unnamed0.604778
Shulan et al22UnnamedDerivation cohort: 0.80
Validation cohort: 0.70
van Walraven et al23LACE+ (extension of a validated index)0.768 (1 hospitalisation per patient)
0.730 (all hospitalisations)
H–L χ2 50.3
H–L χ2 10 972
Cotter et al13LACE index (validation)0.55
Regression model0.57475447
All-cause UHRs (14)
Khan et al24Rehospitalisation risk score1997281998
2158632190
2742812789
Lee25UnnamedROC was graphically illustrated, but no actual number was reported
van Walraven et al26CMG Score0.637p=0.0079
LACE index (validation)0.72P<0.0001
Combined CMG Score and LACE0.743p<0.0001
van Walraven et al27LACE+ (validation)0.743
LACE+ with CMG score0.753
Cardiovascular disease-related UHRs including pneumonia (11)
Hebert et al15CHF model
PNA model
AMI model
Combined model
Derivation cohort: 0.64–0.73;
Historical validation: 0.61–0.68;
Random sample combined: 0.63–0.76
p>0.05
Iannuzzi et al28Vascular surgery readmission risk scoreDerivation dataset: 0.67
Validation dataset: 0.64
0.09
0.66
Keyhani et al29CMS-based model0.6360.866     
CMS-based model plus social risk factors0.6460.462
CMS-based model plus social risk and clinical factors0.6610.856
Rana et al30EMR model0.78565782183.6
HOSPITAL score (validation)0.6062501378.9
Comorbidities (validation)0.536545
Shahian et al31Unnamed0.648
Shams et al32Potentially avoidable readmission (PAR)Retrospective cohort: 0.836
Validation internal: 0.818/external: 0.809
91.9597.6586.6198.65
CMS endorsed model (validation)0.63
Cardiovascular disease-related UHRs including pneumonia (11)
Sharif et al33Unnamed (basic model vs final model)Basic model (patient characteristics only): 0.677; final model (additional provider-level and system-level factors)
Derivation set: 0.717
Validation set: 0.73
Wallmann et al35Unnamed0.75466701098
Wasfy et al36Risk score for 30-day readmission after PCI (parsimonious)Validation data set: 0.67>24
Lucas et al34Complex all-variable modelDerivation data set: 0.721
Validation data set: 0.724
Parsimonious readmission scoreDerivation data set: 0.696
Validation data set: 0.702
1.210008/
2.4996899
4.792281098
877521297
11.855731595
14.637851794
17.221921993
20.39972193
22.221002292
4001004092
Krumholz et al37Claims modelDerivation cohort: 0.63
Validation cohort: 0.62–0.63
Medical record modelDerivation cohort: 0.58
Validation cohort: 0.59
Cardiovascular disease-related UHRs including pneumonia—heart failure only (11)
Betihavas et al38Unnamed0.8
Di Tano et al39Unnamed0.695
Huynh et al40The non-clinical model
The clinical model
The combined model
0.66
0.72
0.76
Raposeiras-Roubin et al41The GRACE risk score0.79p=0.8337.982.562.85.699.1
Sudhakar et al42
USA
Readmission Risk (RR) ScoreAll age group—0.61
≥65 years—0.59
Random selection—0.58
≥2933804769
≥2461524171
≥2183273875
Fleming et al43UnnamedDerivation cohort: 0.69
Validation cohort: 0.66
Wang et al44LACE index (validation)≥10
Eapen et al45 Derivation cohort: 0.59
Validation cohort: 0.59
Zai et al46The telemonitoring-based readmission model0.2150816172
The psychosocial model (validation)0.6787324480
Au et al47Five administrative data-based models0.57–0.61
Watson et al48The psychosocial readmission model0.67
Cardiovascular disease-related UHRs including pneumonia—pneumonia only (2)
Mather et al49Hartford Hospital modelDerivation data set: 0.71
Validation data set: 0.67
p=0.96
Lindenauer et al50Administrative claims model0.63
CMS medical record model0.59
General medical condition-related UHRs (10)
Shadmi et al51PREADMDerivation data set: 0.70
Validation data set: 0.69
Tsui et al52UnnamedDerivation data set: 0.819
Validation data set: 0.824
p<0.05
Donzé et al53Unnamed0.85