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Updated: Jul 2, 2025
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An R-Based Landscape Validation of a Competing Risk Model
Published on: September 16, 2022
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Derivation and validation of a risk-stratification model for patients with probable or proven COVID-19 in EDs: the
Delphine Douillet1,2, Jérémie Riou3,4, François Morin5
1Emergency Department, CHU Angers, University of Angers, CHU Angers, Angers, France delphinedouillet@gmail.com.
Emergency Medicine Journal : EMJ
|February 16, 2024
Summary
A revised HOME-CoV score accurately identifies COVID-19 patients for home treatment. This clinical tool helps safely manage patients, reducing hospital admissions for mild SARS-CoV-2 infections.
Area of Science:
- Infectious Diseases
- Clinical Medicine
- Public Health
Background:
- The HOME-CoV score aids in determining home treatment eligibility for COVID-19 patients.
- The original score required optimization to enhance its predictive accuracy for hospital admission.
Purpose of the Study:
- To refine the HOME-CoV score for improved discrimination between COVID-19 patients needing hospitalization and those suitable for home care.
- To validate the optimized score against existing clinical prediction tools.
Main Methods:
- A revised HOME-CoV score was developed using data from a prospective multicenter study.
- The score was derived and validated on COVID-19 patients from 34 emergency departments in France, Monaco, and Belgium.
- The primary outcome was the need for ventilation or all-cause death within 7 days.
Main Results:
- The revised HOME-CoV score, comprising seven clinical criteria, demonstrated strong predictive performance (AUC 87.6 in derivation, 85.8 in validation).
- A score <2 identified 73% of patients as low-risk with a negative predictive value of 0.99, indicating high safety for home treatment.
- The optimized score showed comparable or superior performance to other clinical scores like qCSI, qSOFA, CRB65, and SMART-COP.
Conclusions:
- The revised HOME-CoV score offers a reliable, laboratory-free method for stratifying COVID-19 patient risk.
- It enables safe and accurate identification of a substantial number of patients eligible for outpatient management of SARS-CoV-2 infection.
- This optimized score can aid clinicians in making informed decisions regarding home-based care for COVID-19.
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