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The primary outcome was natural death at 2\u00a0years, defined as death due to causes other than suicide, homicide, accidental injury, or drug overdose. Cox proportional hazards regression with LASSO for variable selection was used to develop the model. Model performance was assessed by discrimination (area under the receiver operating characteristic curve (AUC) at 2\u00a0years) and calibration (plots of predicted and observed mortality). Classification metrics were assessed at clinically relevant thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>The final cohort included 89,430 adults (median age 40\u00a0years (interquartile range\u2009=\u200920), 10.2%\u2009\u2265\u200960\u00a0years, 30.6% Black, 41.4% Hispanic). At 2\u00a0years, 506 (0.6%) individuals experienced a natural death. The optimism-corrected AUC at 2\u00a0years after bootstrap internal validation was 0.926 (95% confidence interval (CI)\u2009=\u20090.915\u20130.938). The calibration plot at 2\u00a0years suggested good calibration. At a 2-year mortality risk threshold of 5%, sensitivity, specificity, and positive predictive value were 47.6% (95% CI\u2009=\u200942.3\u201351.6%), 98.4% (95% CI\u2009=\u200998.2\u201398.4%), and 16.7% (95% CI\u2009=\u200914.3\u201318.5%), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The mortality risk estimates from this model can help clinicians identify individuals who may most benefit from advance care planning discussions, palliative care services, and compassionate release referrals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-025-10103-w","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T15:58:53Z","timestamp":1766073533000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of a Mortality Prediction Model for Incarcerated Adults to Identify Palliative Care Needs"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7947-3008","authenticated-orcid":false,"given":"W. 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Accessed 8 Nov 2022.","DOI":"10.3389\/fdgth.2022.943768"}],"container-title":["Journal of General Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-025-10103-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11606-025-10103-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-025-10103-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T15:58:56Z","timestamp":1766073536000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11606-025-10103-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,18]]},"references-count":45,"alternative-id":["10103"],"URL":"https:\/\/doi.org\/10.1007\/s11606-025-10103-w","relation":{},"ISSN":["0884-8734","1525-1497"],"issn-type":[{"value":"0884-8734","type":"print"},{"value":"1525-1497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,18]]},"assertion":[{"value":"7 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was reviewed and approved by the University of California, San Francisco Committee on Human Research and CDCR Research Oversight Committee. The need for individual participant consent was waived by these committees as the project involved minimal risk to individual participants and the data used were collected during routine clinical care. All methods were carried out according to the ethical guideline of the Declaration of Helsinki for medical research involving human subjects.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human Ethics and Consent to Participate"}},{"value":"Dr. Sei Lee reports royalties from UpToDate, payments for expert testimony, speaker fees for the Brazilian Geriatrics Society 2024 annual meeting in Sao Paulo, participation on the data safety monitoring board for grant R01AG066892, and a leadership role as board member on the International Geriatric Diabetes Society. Dr. Michele DiTomas reports royalties from UpToDate and travel support from Arnold Ventures for a panel on medical and geriatric parole. Dr. Brie Williams is the Founding Director of Amend at the University of California, San Francisco, which brings a public health lens to reduce harm and improve the health and well-being of people who live or work in prisons. The other authors report no conflicts of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}