Automated Machine Learning for Predicting Pressure Injury Risk in Home Care Centers Throughout Taiwan.

Objective: Pressure injuries (PIs) are a common issue among patients, particularly in home care centers. PIs lead to increased complications and increased healthcare costs. This study aimed to predict the occurrence of PIs among patients in Taiwan's home care centers using electronic health records...

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Published in:Health & Social Care in the Community Vol. 2026; pp. 1 - 19
Main Authors: Tsay, Shwu-Feng, Lai, Jih Mei, Chou, Yen-Ting, Liao, Gen-Yih, Chen, Ssu-Han, Niroumand Sarvandani, Mohammad
Format: pictorial research tables/charts Journal Article
Published: Wiley-Blackwell 1/17/2026
Online Access:View this record in EBSCOhost
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      dt: 1/17/2026
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Automated Machine Learning for Predicting Pressure Injury Risk in Home Care Centers Throughout Taiwan.
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        au:
          Tsay, Shwu-Feng
          Lai, Jih Mei
          Chou, Yen-Ting
          Liao, Gen-Yih
          Chen, Ssu-Han
          Niroumand Sarvandani, Mohammad
        affil: Department of Nursing and Healthcare,, Ministry of Health and Welfare,, Taipei, Taiwan, mohw.gov.tw
      sug:
        subj:
          Home Health Care Taiwan
          Pressure Ulcer Risk Factors
          Risk Assessment Methods
          Machine Learning
          Prediction Models
          Automation
          Electronic Health Records Utilization
          Pressure Ulcer Epidemiology
          Human
          Taiwan
          Prediction Algorithms
          Pressure Ulcer Etiology
          Retrospective Design
          Record Review
          Holistic Care Evaluation
          Nursing Assessment
          Prevalence
          Factorial Design
          Validity
          Chronic Disease
          Polypharmacy
          Nutritional Status
          Community Living
          Pressure Ulcer Prevention and Control
          Funding Source
          Scales
          Braden Scale for Predicting Pressure Sore Risk
          Barthel Index
          Geriatric Depression Scale
          Short Portable Mental Status Questionnaire
          Questionnaires
          Clinical Assessment Tools
          Descriptive Statistics
          Data Analysis Software
      ab: Objective: Pressure injuries (PIs) are a common issue among patients, particularly in home care centers. PIs lead to increased complications and increased healthcare costs. This study aimed to predict the occurrence of PIs among patients in Taiwan's home care centers using electronic health records (EHRs) from the proposed Home Care Management System (HCMS). Design: A retrospective study was conducted. Setting and Participants: Nurses completed the holistic healthcare assessment (HHCA) for 36,896 patients. The data collection duration covered the period from October 2021 to May 2023. The study analyzed 44,188 cases, with a PI prevalence of approximately 31%. Methods: This study employed an automated machine learning (AutoML) approach. The AutoML systematically and efficiently selected modeling strategies and tuned hyperparameters using a partial factorial design. This approach reduced the number of trials needed for optimal model performance. Results: On the independent hold‐out testing set, the final model achieved an accuracy of 77.56% and an AUC of 81.82%. Not only can top risk factors be identified but also the Shapley additive explanations (SHAP) are employed at an individual level over time. Conclusions and Implications: This study represents one of the first large‐scale applications of AutoML for PI prediction in the home care setting, a context that differs substantially from both nursing homes and hospitals. Our findings emphasize Braden assessment, chronic disease burden, polypharmacy, and nutritional status as the dominant predictors in community‐dwelling patients receiving professional home care. By extending predictive analytics into this underexplored domain, the study demonstrates how risk models can be operationalized to support home care nurses. In particular, SHAP‐based waterfall plots guide nurses to detect whether specific risk features are improving or worsening and to adjust care plans accordingly.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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