Journal of Clinical Epidemiology
Volume 52, Issue 12 , Pages 1157-1163, December 1999

Validation of a Predictive Model for Asthma Admission in Children:

How Accurate Is it for Predicting Admissions?

  • Tien Chey

      Affiliations

    • Epidemiology Unit, Southwestern Sydney Area Health Service, Sydney, Australia
    • Corresponding Author InformationAddress correspondence to: Tien Chey, Epidemiology Unit, Hugh Jardine Building, Liverpool Hospital, Elizabeth Street, Liverpool NSW 2170, Australia.
  • ,
  • Bin Jalaludin

      Affiliations

    • Western Sector Public Health Unit, Western Sydney Area Health Service, Sydney, Australia
  • ,
  • Ralph Hanson

      Affiliations

    • The New Children's Hospital, Sydney, Australia
  • ,
  • Stephen Leeder

      Affiliations

    • Faculty of Medicine, University of Sydney, Australia

Accepted 7 May 1999.

Abstract 

We studied 364 index presentations to the Emergency Department of a children's hospital with a diagnosis of asthma. The admission rate for this group of children was about 31%. We developed a parsimonious multiple logistic regression model to predict asthma hospital admission based on asthma severity indicators. We then evaluated the model's predictive ability using two methods of cross-validation, using the same sample that was used for the predictive model, and using data from a split sample. The logistic regression model had a predictive accuracy of 90% (95% confidence interval 85–95%). The sensitivity and specificity were 86% and 88%, respectively. Cross-validation models confirmed that the predictive ability of the model was stable. In studies with limited sample sizes, it is possible to validate a model without setting aside a split sample for cross-validation.

Keywords:  Predictive model, cross-validation model, asthma admission, receiver operator characteristic curve, sensitivity, specificity

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PII: S0895-4356(99)00111-0

Journal of Clinical Epidemiology
Volume 52, Issue 12 , Pages 1157-1163, December 1999