Predictive modelling in times of public health emergencies: patients’ non-transport decisions during the COVID-19 pandemic

<h3>Background</h3><p dir="ltr">During the COVID-19 pandemic, there was a surge in pre-hospital emergency calls due to the increased prevalence of flu-like symptoms and panic related to the pandemic. However, some patients declined transportation to hospital due to their...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Hassan Farhat (9000509) (author)
مؤلفون آخرون: Cyrine Abid (18464455) (author), Guillaume Alinier (6952004) (author), Moncef Khadhraoui (14778526) (author), Imed Gargouri (14778529) (author), Loua Al Shaikh (22234264) (author), James Laughton (14778532) (author)
منشور في: 2025
الموضوعات:
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author Hassan Farhat (9000509)
author2 Cyrine Abid (18464455)
Guillaume Alinier (6952004)
Moncef Khadhraoui (14778526)
Imed Gargouri (14778529)
Loua Al Shaikh (22234264)
James Laughton (14778532)
author2_role author
author
author
author
author
author
author_facet Hassan Farhat (9000509)
Cyrine Abid (18464455)
Guillaume Alinier (6952004)
Moncef Khadhraoui (14778526)
Imed Gargouri (14778529)
Loua Al Shaikh (22234264)
James Laughton (14778532)
author_role author
dc.creator.none.fl_str_mv Hassan Farhat (9000509)
Cyrine Abid (18464455)
Guillaume Alinier (6952004)
Moncef Khadhraoui (14778526)
Imed Gargouri (14778529)
Loua Al Shaikh (22234264)
James Laughton (14778532)
dc.date.none.fl_str_mv 2025-09-11T06:00:00Z
dc.identifier.none.fl_str_mv 10.1186/s12873-025-01340-7
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Predictive_modelling_in_times_of_public_health_emergencies_patients_non-transport_decisions_during_the_COVID-19_pandemic/30135670
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Health sciences
Epidemiology
Health services and systems
Information and computing sciences
Artificial intelligence
Data management and data science
Machine learning
Pre-hospital
EMS
Non-transport
Machine learning
Prediction
dc.title.none.fl_str_mv Predictive modelling in times of public health emergencies: patients’ non-transport decisions during the COVID-19 pandemic
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">During the COVID-19 pandemic, there was a surge in pre-hospital emergency calls due to the increased prevalence of flu-like symptoms and panic related to the pandemic. However, some patients declined transportation to hospital due to their fear of accessing healthcare facilities. This posed a significant risk to their health outcomes. This study aimed to utilise an extensive dataset, which included the period of the COVID-19 pandemic, in a modern Middle Eastern Emergency Medical Service to comprehend and predict the behaviour of non-transport decisions, a major multi-variable factor in pre-hospital emergency medicine. </p><h3>Methods</h3><p dir="ltr">Using Python® programming language, this study employed various supervised machine-learning algorithms, including parametric probabilistic models, such as logistic regression, and non-parametric models, including decision trees, random forest (RF), extra trees, AdaBoost, and k-nearest neighbours (KNN), using a dataset of non-transported patients (refused transport and did not receive treatment versus those who refused transport and received treatment) between 2018 and 2022. Model performance was comprehensively evaluated using Accuracy, F1 score, Matthews correlation coefficient (MCC), receiver operating characteristic area under the curve (ROC AUC), kappa, and R-squared metrics to ensure robust model selection. </p><h3>Results</h3><p dir="ltr">From June 2018 to July 2022, 334,392 non-transport cases were recorded. The random forest model demonstrated the best optimised predictive performance, with accuracy = 74.78%, F1 = 0.74, MCC = 0.35, ROC AUC = 0.81, kappa = 0.34, and R-squared = 0.81. </p><h3>Conclusion</h3><p dir="ltr">This study indicated that predictive modelling could accurately help identify patients who refuse transport to hospital and may not require treatment on the scene. This enables them to be redirected from the call-taking phase to alternative primary healthcare facilities. This reduces the strain on emergency healthcare resources. The findings suggest that machine learning has the potential to revolutionise pre-hospital care, especially during pandemics, by improving resource allocation and patient outcomes, while highlighting the need for ongoing research to refine these models.</p><h2>Other Information</h2><p dir="ltr">Published in: BMC Emergency Medicine<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12873-025-01340-7" target="_blank">https://dx.doi.org/10.1186/s12873-025-01340-7</a></p>
eu_rights_str_mv openAccess
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network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/30135670
publishDate 2025
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spelling Predictive modelling in times of public health emergencies: patients’ non-transport decisions during the COVID-19 pandemicHassan Farhat (9000509)Cyrine Abid (18464455)Guillaume Alinier (6952004)Moncef Khadhraoui (14778526)Imed Gargouri (14778529)Loua Al Shaikh (22234264)James Laughton (14778532)Health sciencesEpidemiologyHealth services and systemsInformation and computing sciencesArtificial intelligenceData management and data scienceMachine learningPre-hospitalEMSNon-transportMachine learningPrediction<h3>Background</h3><p dir="ltr">During the COVID-19 pandemic, there was a surge in pre-hospital emergency calls due to the increased prevalence of flu-like symptoms and panic related to the pandemic. However, some patients declined transportation to hospital due to their fear of accessing healthcare facilities. This posed a significant risk to their health outcomes. This study aimed to utilise an extensive dataset, which included the period of the COVID-19 pandemic, in a modern Middle Eastern Emergency Medical Service to comprehend and predict the behaviour of non-transport decisions, a major multi-variable factor in pre-hospital emergency medicine. </p><h3>Methods</h3><p dir="ltr">Using Python® programming language, this study employed various supervised machine-learning algorithms, including parametric probabilistic models, such as logistic regression, and non-parametric models, including decision trees, random forest (RF), extra trees, AdaBoost, and k-nearest neighbours (KNN), using a dataset of non-transported patients (refused transport and did not receive treatment versus those who refused transport and received treatment) between 2018 and 2022. Model performance was comprehensively evaluated using Accuracy, F1 score, Matthews correlation coefficient (MCC), receiver operating characteristic area under the curve (ROC AUC), kappa, and R-squared metrics to ensure robust model selection. </p><h3>Results</h3><p dir="ltr">From June 2018 to July 2022, 334,392 non-transport cases were recorded. The random forest model demonstrated the best optimised predictive performance, with accuracy = 74.78%, F1 = 0.74, MCC = 0.35, ROC AUC = 0.81, kappa = 0.34, and R-squared = 0.81. </p><h3>Conclusion</h3><p dir="ltr">This study indicated that predictive modelling could accurately help identify patients who refuse transport to hospital and may not require treatment on the scene. This enables them to be redirected from the call-taking phase to alternative primary healthcare facilities. This reduces the strain on emergency healthcare resources. The findings suggest that machine learning has the potential to revolutionise pre-hospital care, especially during pandemics, by improving resource allocation and patient outcomes, while highlighting the need for ongoing research to refine these models.</p><h2>Other Information</h2><p dir="ltr">Published in: BMC Emergency Medicine<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12873-025-01340-7" target="_blank">https://dx.doi.org/10.1186/s12873-025-01340-7</a></p>2025-09-11T06:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1186/s12873-025-01340-7https://figshare.com/articles/journal_contribution/Predictive_modelling_in_times_of_public_health_emergencies_patients_non-transport_decisions_during_the_COVID-19_pandemic/30135670CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/301356702025-09-11T06:00:00Z
spellingShingle Predictive modelling in times of public health emergencies: patients’ non-transport decisions during the COVID-19 pandemic
Hassan Farhat (9000509)
Health sciences
Epidemiology
Health services and systems
Information and computing sciences
Artificial intelligence
Data management and data science
Machine learning
Pre-hospital
EMS
Non-transport
Machine learning
Prediction
status_str publishedVersion
title Predictive modelling in times of public health emergencies: patients’ non-transport decisions during the COVID-19 pandemic
title_full Predictive modelling in times of public health emergencies: patients’ non-transport decisions during the COVID-19 pandemic
title_fullStr Predictive modelling in times of public health emergencies: patients’ non-transport decisions during the COVID-19 pandemic
title_full_unstemmed Predictive modelling in times of public health emergencies: patients’ non-transport decisions during the COVID-19 pandemic
title_short Predictive modelling in times of public health emergencies: patients’ non-transport decisions during the COVID-19 pandemic
title_sort Predictive modelling in times of public health emergencies: patients’ non-transport decisions during the COVID-19 pandemic
topic Health sciences
Epidemiology
Health services and systems
Information and computing sciences
Artificial intelligence
Data management and data science
Machine learning
Pre-hospital
EMS
Non-transport
Machine learning
Prediction