Evaluating sepsis watch generalizability through multisite external validation of a sepsis machine learning model

Abstract

Sepsis accounts for a substantial portion of global deaths and healthcare costs. The objective of this reproducibility study is to validate Duke Health’s Sepsis Watch ML model, in a new community healthcare setting and assess its performance and clinical utility in early sepsis detection at Summa Health’s emergency departments. The study analyzed the model’s ability to predict sepsis using a combination of static and dynamic patient data using 205,005 encounters between 2020 and 2021 from 101,584 unique patients. 54.7% (n = 112,223) patients were female and the average age was 50 (IQR [38,71]). The AUROC ranged from 0.906 to 0.960, and the AUPRC ranged from 0.177 to 0.252 across the four sites. Ultimately, the reproducibility of the Sepsis Watch model in a community health system setting confirmed its strong and robust performance and portability across different geographical and demographic contexts with little variation.