{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T05:58:08Z","timestamp":1757311088800,"version":"3.40.5"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"crossref","award":["17\/363"],"award-info":[{"award-number":["17\/363"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The ability to accurately predict the one-year survival of older adults is challenging for clinicians as they endeavour to provide the most appropriate care. Standardised clinical needs assessments are routine in many countries and some enable application of mortality prediction models. The added value of blood biomarkers to these models is largely unknown. We undertook a proof of concept study to assess if adding biomarkers to needs assessments is of value. Assessment of the incremental value of a blood biomarker, Brain Naturetic Peptide (BNP), to a one year mortality risk prediction model, RiskOP, previously developed from data from the international interRAI-HomeCare (interRAI-HC) needs assessment. Participants were aged \u226565 years and had completed an interRAI-HC assessment between 1 January 2013 and 21 August 2021 in Canterbury, New Zealand. Inclusion criteria was a BNP test within 90 days of the date of interRAI-HC assessment. The primary outcome was one-year mortality. Incremental value was assessed by change in Area Under the Receiver Operating Characteristic Curve (AUC) and Brier Skill, and the calibration of the final model. Of 14,713 individuals with an interRAI-HC assessment 1,537 had a BNP within 90 days preceding the assessment and all data necessary for RiskOP. 553 (36.0%) died within 1-year. The mean age was 82.6 years. Adding BNP improved the overall AUC by 0.015 (95% CI:0.004 to 0.028) and improved predictability by 1.9% (0.26% to 3.4%). In those with no Congestive Heart Failure the improvements were 0.029 (0.004 to 0.057) and 4.0% (0.68% to 7.6%). Adding a biomarker to a risk model based on standardised needs assessment of older people improved prediction of 1-year mortality. BNP added value to a risk prediction model based on the interRAI-HC assessment in those patients without a diagnosis of congestive heart failure.<\/jats:p>","DOI":"10.1371\/journal.pone.0277850","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T18:28:25Z","timestamp":1668796105000},"page":"e0277850","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of the added value of Brain Natriuretic Peptide to a validated mortality risk-prediction model in older people using a standardised international clinical assessment tool"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9475-0344","authenticated-orcid":true,"given":"John 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Indices for Advance Care Planning in Primary Care: A Scoping Review","volume":"33","author":"P Kim","year":"2020","journal-title":"J Am Board Fam Med."},{"key":"pone.0277850.ref003","doi-asserted-by":"crossref","first-page":"e2696","DOI":"10.1097\/MD.0000000000002696","article-title":"Predictive Mortality Index for Community-Dwelling Elderly Koreans","volume":"95","author":"NH Kim","year":"2016","journal-title":"Medicine (Baltimore)."},{"key":"pone.0277850.ref004","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1136\/jech.39.4.337","article-title":"Factors predicting mortality in a total population sample of the elderly","volume":"39","author":"AJ Campbell","year":"1985","journal-title":"J Epidemiol Community Health"},{"key":"pone.0277850.ref005","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/j.jclinepi.2010.10.004","article-title":"A combined comorbidity score predicted mortality in elderly patients better than existing scores.","volume":"64","author":"JJ Gagne","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"pone.0277850.ref006","doi-asserted-by":"crossref","first-page":"j2099","DOI":"10.1136\/bmj.j2099","article-title":"Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study","author":"J Hippisley-Cox","year":"2017","journal-title":"BMJ"},{"key":"pone.0277850.ref007","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1186\/1472-6963-8-277","article-title":"Reliability of the interRAI suite of assessment instruments: a 12-country study of an integrated health information system","volume":"8","author":"JP Hirdes","year":"2008","journal-title":"BMC Health Serv Res"},{"key":"pone.0277850.ref008","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1111\/1753-6405.12525","article-title":"Comprehensive clinical assessment of home-based older persons within New Zealand: an epidemiological profile of a national 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