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Given the operating environment where the model was going to be implemented and the clinical use of the model, the modeling options were restricted to models that could be easily instantiated in Java and that would allow the identification of the specific model components with a substantial contribution to the score at the time when the score exceeded the defined cutoff (an alert). Some ensemble models included weighted combinations of estimates from various models stratified by the most predictive variables.
Our final model was a discrete-time logistic regression equation that is easily programmed into Java for real time scoring. A discrete time logistic regression model is similar to the counting process Cox proportional and hazards model with several attractive features: time varying covariates can be easily estimated; competing risks models are more intuitive and easy to interpret, and obtaining estimates more often than on an hourly basis is not necessary and can be overwhelming.