{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T02:12:00Z","timestamp":1778292720600,"version":"3.51.4"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":1261,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"British Heart Foundation Centre of Research Excellence","award":["RE\/18\/6\/34217"],"award-info":[{"award-number":["RE\/18\/6\/34217"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Risk changes with the progression of disease and the impact of treatment. We developed a dynamic risk stratification Markov chain model using artificial intelligence in patients with chronic heart failure (CHF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We described the pattern of behaviour among 7496 consecutive patients assessed for suspected HF. The following mutually exclusive health states were defined and assessed every 4 months: death, hospitalization, outpatient visit, no event, and leaving the service altogether (defined as no event at any point following assessment). The observed figures at the first transition (4 months) weres 427 (6%), 1559 (21%), 2254 (30%), 1414 (19%), and 1842 (25%), respectively. The probabilities derived from the first two transitions (i.e. from baseline to 4 months and from 4 to 8 months) were used to construct the model. An example of the model's prediction is that at cycle 4, the cumulative probability of death was 14%; leaving the system, 37%; being hospitalized between 12 and 16 months, 10%; having an outpatient visit, 8%; and having no event, 31%. The corresponding observed figures were 14%, 41%, 10%, 15%, and 21%, respectively. The model predicted that during the first 2 years, a patient had a probability of dying of 0.19, and the observed value was 0.18.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A model derived from the first 8 months of follow-up is strongly predictive of future events in a population of patients with chronic heart failure. The course of CHF is more linear than is commonly supposed, and thus more predictable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14028","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T09:35:30Z","timestamp":1655976930000},"page":"3009-3018","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Dynamic Risk Stratification Using Markov Chain Modelling in Patients with Chronic Heart Failure"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1885-0471","authenticated-orcid":false,"given":"Syed","family":"Kazmi","sequence":"first","affiliation":[{"name":"Department of Academic Cardiology, Hull University Teaching Hospital NHS Trust , Hull ,","place":["UK"]},{"name":"Department of Computer Science and Technology, University of Hull , Hull ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9110-2763","authenticated-orcid":false,"given":"Chandrasekhar","family":"Kambhampati","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Technology, University of Hull , Hull ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1471-7016","authenticated-orcid":false,"given":"John G.F.","family":"Cleland","sequence":"additional","affiliation":[{"name":"Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joe","family":"Cuthbert","sequence":"additional","affiliation":[{"name":"Department of Academic Cardiology, Hull University Teaching Hospital NHS Trust , Hull ,","place":["UK"]},{"name":"Department of Cardiorespiratory Medicine, Centre for Clinical Sciences, Hull York Medical School, University of Hull , Hull ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khurram Shehzad","family":"Kazmi","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Ghurki Trust Teaching Hospital , Lahore ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7175-0464","authenticated-orcid":false,"given":"Pierpaolo","family":"Pellicori","sequence":"additional","affiliation":[{"name":"Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan S.","family":"Rigby","sequence":"additional","affiliation":[{"name":"Hull York Medical School, University of Hull , Hull ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew L.","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Academic Cardiology, Hull University Teaching Hospital NHS Trust , Hull ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"2026012114161798200_ehf214028-bib-0001","article-title":"Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: Population based cohort study","volume":"364","author":"Taylor","year":"2019","journal-title":"BMJ"},{"key":"2026012114161798200_ehf214028-bib-0002","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1586\/14779072.2014.935340","article-title":"Remote telemonitoring for patients with heart failure: Might monitoring pulmonary artery pressure become routine?","volume":"12","author":"Hutchinson","year":"2014","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"2026012114161798200_ehf214028-bib-0003","volume-title":"&gt;National Heart Failure Audit Report UK National Heart Failure Audit (NHFA) The National Institute for Cardovascular Outcomes Research (NICOR)","year":"2019"},{"key":"2026012114161798200_ehf214028-bib-0004","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1161\/CIRCRESAHA.113.300268","article-title":"Epidemiology of heart failure","volume":"113","author":"Roger","year":"2013","journal-title":"Circ Res"},{"key":"2026012114161798200_ehf214028-bib-0005","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1002\/ejhf.505","article-title":"Is the diagnostic coding position of acute heart failure related to mortality? 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