{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T01:00:32Z","timestamp":1789952432202,"version":"4.0.1"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Clinical prediction models traditionally rely on measurements obtained at a single time point to estimate risk and guide management. However, the clinical status of hospitalized children often evolves during admission, and time-varying measurements obtained over the course of hospitalization may provide more accurate, dynamic estimates of risk that better reflect clinical trajectories. Time-varying prediction models are therefore an increasingly important methodological opportunity for pediatric hospitalists seeking to leverage patient-specific longitudinal data in clinical practice. In this article, we review the development of clinical prediction models using time-varying predictors in pediatric hospital medicine, including appropriate clinical settings and data recording, data structuring, analytic approaches, and advantages and limitations. We illustrate these principles using a published example of a time-varying model developed to predict in-hospital mortality among severely malnourished children, highlighting how incorporating daily clinical signs improved predictive accuracy compared with a single time point model using admission data alone.<\/jats:p>","DOI":"10.1542\/hpeds.2026-009395","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:03:27Z","timestamp":1789949007000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical Prediction With Time-Varying Predictors in Pediatric Hospital Medicine"],"prefix":"10.1542","author":[{"given":"Alastair","family":"Fung","sequence":"first","affiliation":[{"name":"1Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Beyene","sequence":"additional","affiliation":[{"name":"2Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"D\u2019Arienzo","sequence":"additional","affiliation":[{"name":"3Department of Pediatrics, The Montreal Children\u2019s Hospital, McGill University, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi P.","family":"Mediratta","sequence":"additional","affiliation":[{"name":"4Division of Pediatric Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"issue":"1","key":"2026092020032267300_r1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1186\/s12879-023-08179-y","article-title":"Development and validation of a nomogram for predicting severe respiratory syncytial virus-associated bronchiolitis","volume":"23","author":"Yan","year":"2023","journal-title":"BMC Infect Dis."},{"issue":"5","key":"2026092020032267300_r2","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/j.acap.2024.03.016","article-title":"Clinical prediction models in children that use repeated measurements with time-varying covariates: a scoping review","volume":"24","author":"Fung","year":"2024","journal-title":"Acad Pediatr."},{"issue":"1","key":"2026092020032267300_r3","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1186\/s12874-019-0847-0","article-title":"Incorporating repeated measurements into prediction models in the critical care setting: a framework, systematic review and meta-analysis","volume":"19","author":"Plate","year":"2019","journal-title":"BMC Med Res Methodol."},{"issue":"1","key":"2026092020032267300_r4","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1186\/s12916-021-02074-6","article-title":"Predicting the risk of mortality during hospitalization in sick severely malnourished children using daily evaluation of key clinical warning signs","volume":"19","author":"Wen","year":"2021","journal-title":"BMC Med."},{"issue":"6","key":"2026092020032267300_r5","doi-asserted-by":"crossref","first-page":"e280","DOI":"10.1542\/hpeds.2024-008218","article-title":"Principles of clinical prediction model development and validation","volume":"15","author":"Fung","year":"2025","journal-title":"Hosp Pediatr."},{"key":"2026092020032267300_r6","article-title":"Using time dependent covariates and time dependent coefficients in the Cox model","author":"Therneau"},{"issue":"12","key":"2026092020032267300_r7","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1016\/0895-4356(95)00048-8","article-title":"Importance of events per independent variable in proportional hazards regression analysis. 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