Artificial intelligence-driven prediction of COVID-19-related hospitalization and death: a systematic review

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Aim: To perform a systematic review on the use of Artificial Intelligence (AI) techniques for predicting COVID-19 hospitalization and mortality using primary and secondary data sources. Study eligibility criteria: Cohort, clinical trials, meta-analyses, and observational studies investigating COVID-19 hospitalization or mortality using artificial intelligence techniques were eligible. Articles without a full text available in the English language were excluded. Data sources: Articles recorded in Ovid MEDLINE from 01/01/2019 to 22/08/2022 were screened. Data extraction: We extracted information on data sources, AI models, and epidemiological aspects of retrieved studies. Bias assessment: A bias assessment of AI models was done using PROBAST. Participants: Patients tested positive for COVID-19. Results: We included 39 studies related to AI-based prediction of hospitalization and death related to COVID-19. The articles were published in the period 2019-2022, and mostly used Random Forest as the model with the best performance. AI models were trained using cohorts of individuals sampled from populations of European and non-European countries, mostly with cohort sample size <5,000. Data collection generally included information on demographics, clinical records, laboratory results, and pharmacological treatments (i.e., high-dimensional datasets). In most studies, the models were internally validated with cross-validation, but the majority of studies lacked external validation and calibration. Covariates were not prioritized using ensemble approaches in most of the studies, however, models still showed moderately good performances with Area under the Receiver operating characteristic Curve (AUC) values >0.7. According to the assessment with PROBAST, all models had a high risk of bias and/or concern regarding applicability. Conclusions: A broad range of AI techniques have been used to predict COVID-19 hospitalization and mortality. The studies reported good prediction performance of AI models, however, high risk of bias and/or concern regarding applicability were detected.

Original languageEnglish
Article number1183725
JournalFrontiers in Public Health
Volume11
Number of pages15
ISSN2296-2565
DOIs
Publication statusPublished - 2023

Bibliographical note

Funding Information:
This work was performed as part of the Nordic COHERENCE Project, Project No. 105670 funded by NordForsk under the Nordic Council of Ministers and the EU-COVID-19 Project, Project No. 312707 funded by the Norwegian Research Council and by a grant from the Novo Nordisk Foundation to the University of Copenhagen (NNF15SA0018404). The Swedish SCIFI-PEARL project has received basic funding from the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (Avtal om Läkarutbildning och Forskning/Medical Training and Research Agreement) grants ALFGBG-938453, ALFGBG-971130, ALFGBG-978954 and during 2020–2021 had funding from FORMAS (Forskningsrådet för miljö, areella näringar och samhällsbyggande/Research Council for Environment, Agricultural Sciences and Spatial Planning), a Government Research Council for Sustainable Development, Grant 2020-02828. Additional grants supporting different aspects of ongoing research within the study include: the Swedish Heart Lung Foundation (20210030 and 2021-0581), grants from the SciLifeLab National COVID-19 Research Program, financed by the Knut och Alice Wallenberg Foundation (KAW 2020.0299), the Swedish Research Council (2021-05045, 2021-05450), the Swedish Social Insurance Agency (FK 2021/011186) and Forte (Swedish Research Council for Health, Working Life and Welfare), grant 2022-00444.

    Research areas

  • AI, bias, COVID-19, pharmacoepidemiology, predictive modeling, PROBAST

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