Heart failure & cardiomyopathies

Machine Learning Prediction of Heart Failure Readmissions: Insights From a Multicenter Emergency Department Trial

JACC AdvPublished subanalysis of a cluster randomized clinical trial

Authors' conclusion

An XGB-based ML model accurately predicted 12-month HF readmission following ED presentation and outperformed traditional regression methods, supporting its potential role in early risk stratification and targeted preventive care.

Study context

Population
Patients presenting to emergency department (EDs) with suspected cardiac conditions, with symptoms warranting high-sensitivity cardiac troponin T testing, enrolled April-December 2023ED patients (mean age 61 years, 49% female)
Participants
14,131 patients
Comparison
Four machine learning (ML) algorithms were compared with logistic regression
Methodological details12 South Australia EDs, training (70%) and test (30%) sets, Four ML algorithms were compared with logistic regression
  • 12 South Australia EDs
  • Training (70%) and test (30%) sets
  • Four ML algorithms were compared with logistic regression

Primary result

As reported in the abstract

HF readmission · 12 months

Readmitted for heart failure (HF)

808

5.71%

Median time to readmission

83 days

IQR: 27–178

Further findings

OutcomeValuesP value
Prediction of HF readmission (AUC), test set · XGB outperformed logistic regressioneXtreme Gradient Boosting (XGB) AUC 0.861 (95% CI 0.847–0.875) · logistic regression AUC 0.846 (95% CI 0.828–0.861) · random forest AUC 0.845 · least absolute shrinkage and selection operator AUC 0.851 · neural networks AUC 0.842P = 0.015

Calibration of XGB

Brier score for XGB
0.151
  • Demonstrating good model calibration

Original publication

Machine Learning Prediction of Heart Failure Readmissions: Insights From a Multicenter Emergency Department Trial. JACC Adv. Published 22 June 2026. doi:10.1016/j.jacadv.2026.102931

Summarised from the published abstract; every number is checked against it

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