Cardiovascular disease remains the leading global cause of death, emphasizing the need for improved risk stratification beyond traditional tools such as Framingham, ASCVD, QRISK, and SCORE, which show limitations in diverse modern populations. Machine learning methods applied to electronic health records can enhance prediction by capturing complex, high-dimensional, and nonlinear relationships. This systematic review (2017–2022) evaluated machine learning models for cardiovascular risk prediction using EHR data, focusing on discrimination (AUROC, AUPRC), calibration, external validation, and reporting quality including TRIPOD adherence. A PRISMA-compliant search identified peer-reviewed studies applying machine learning to EHR-based cardiovascular risk prediction. Risk of bias was assessed using PROBAST, and narrative synthesis was conducted due to heterogeneity. Twenty-nine studies were included. XGBoost, random forest, and neural networks were the most common models and generally outperformed logistic regression and traditional risk scores in discrimination. However, calibration was infrequently reported, and external validation was limited, often showing reduced performance. Machine learning models demonstrate improved predictive discrimination over conventional risk scores, but limited calibration assessment and weak external validation constrain clinical applicability. Stronger validation frameworks are needed for clinical translation.
Suicidality and depression are major global health burdens, with over 700,000 suicide deaths annually and ~280 million people affected by major depressive disorder. Early risk prediction could support prevention, but traditional methods show limited accuracy. This PRISMA-compliant systematic review evaluated machine learning models for predicting suicidality and depression across electronic health records, social media, and wearable sensor data, focusing on performance, unimodal vs multimodal approaches, and ethical reporting. Searches of PubMed, PsycINFO, IEEE Xplore, arXiv, and ACM Digital Library identified eligible studies. EHR-based models showed AUROC 0.70–0.85 for suicide attempt prediction, social media models 0.70–0.80 for suicidal ideation, and wearable sensor models lower performance (0.65–0.75). Multimodal approaches improved performance by 5–10% over unimodal models. However, fewer than 20% of studies reported ethical considerations such as privacy, bias, or deployment safeguards. Overall, machine learning shows moderate-to-good predictive performance, with multimodal models performing best, but ethical reporting remains critically insufficient for clinical translation.
Sepsis continues to be a major contributor to morbidity and mortality among hospitalized patients globally, especially within intensive care and emergency departments, where rapid recognition is essential for improving survival through timely treatment. In recent years, machine learning approaches have gained attention for their ability to predict sepsis onset using routinely collected electronic health record data. This systematic review, conducted in accordance with PRISMA 2020 guidelines, synthesizes evidence from studies published between 2017 and 2025, focusing on model architectures, feature selection and engineering strategies, prediction time horizons, and validation methodologies. Searches across major biomedical and informatics databases identified 67 eligible studies. The included literature shows that logistic regression, ensemble tree-based algorithms, and deep learning models are most frequently applied for sepsis prediction tasks. However, the majority of studies rely on retrospective datasets with internal validation, while only a limited number incorporate prospective or real-world validation frameworks. Overall, although reported model performance is often strong in retrospective analyses, a consistent decline in accuracy is observed when models are evaluated in real clinical environments. These findings highlight that prospective validation and improved generalizability are still underdeveloped areas, underscoring the need for future research to emphasize real-time deployment and robust external validation before clinical integration.
Clinical trial recruitment is hindered by slow, costly, and labor-intensive processes, particularly due to the complexity of eligibility criteria often written in free text. This systematic review examines the use of large language models (LLMs) for matching clinical trial eligibility criteria to electronic health records (EHR). It evaluates zero-shot, few-shot, and fine-tuned LLM approaches, comparing their strengths, limitations, and deployment readiness in supporting patient-trial matching. Thirty-three studies published from 2017 to 2026 were included, with findings showing that zero-shot prompting is most adaptable for simple criteria, few-shot prompting offers consistent reasoning for ambiguous criteria, and fine-tuned models excel in task-specific performance but require labeled data and are less portable. The review concludes that no single approach is optimal for all trial screening tasks, and hybrid workflows combining various methods with human verification are most suitable for clinical use.