Table 3.
Critical Appraisal of Models that Predict Readmission (CAMPR)
| Number | Recommendation | Studies following recommendation (n) | P value* | ||
| Overall, n=81 (1985–2015) |
Early, n=26 (1985–2010) |
Recent, n=55 (2011–2015) |
|||
| #1 | Is the model’s purpose and eligibility criteria explicitly stated? | 44 (54%) | 11 (42%) | 33 (60%) | 0.14 |
| #2 | Does the model consider common patient-related and institution-related risk factors for readmission? | 1 (1%) | 1 (4%) | 0 (0%) | 0.33 |
| #3 | Does the model consider competing risks to readmission, particularly mortality? | 68 (84%) | 23 (88%) | 45 (82%) | 0.43 |
| #4 | Does the model identify how providers may intervene to prevent readmission? | 4 (5%) | 3 (12%) | 1 (2%) | 0.15 |
| #5 | Does the model consider recent changes in the patient’s condition? | 39 (48%) | 6 (23%) | 33 (60%) | 0.001** |
| #6 | Is the model’s timeframe an appropriate trade-off between sensitivity and statistical power? | 12 (15%) | 4 (15%) | 8 (15%) | 0.92 |
| #7 | Does the model exclude either planned or unavoidable readmissions? | 42 (52%) | 12 (46%) | 30 (55%) | 0.49 |
| #8 | Is the model equipped to handle missing data and is missingness in the development datasets reported? | 13 (16%) | 4 (15%) | 9 (16%) | 0.91 |
| #9 | Is preprocessing discussed and does the model avoid problematic preprocessing, particularly binning? | 27 (33%) | 9 (35%) | 18 (33%) | 0.96 |
| #10 | Does the model make use of all available data sources to improve performance? | 59 (73%) | 15 (58%) | 44 (80%) | 0.05 |
| #11 | Does the model use electronically available data rather than relying on manual data entry? | 55 (68%) | 17 (65%) | 38 (69%) | 0.75 |
| #12 | Does the model rely on data available in sufficient quantity and quality for prediction? | 58 (72%) | 18 (69%) | 40 (73%) | 0.75 |
| #13 | Is the model internally validated using cross-validation or a similarly rigorous method? | 4 (5%) | 1 (4%) | 3 (5%) | 0.75 |
| #14 | Is the model’s discrimination reported and compared with known models where appropriate? | 74 (91%) | 21 (81%) | 53 (96%) | 0.07 |
| #15 | Is the model calibrated if needed and is calibration reported? | 47 (58%) | 14 (54%) | 33 (60%) | 0.61 |
*Significant at p=0.05; **significant at p=0.001.
*Comparison is between models published earlier (1985–2010) and more recently (2011–2015).