Real-world cohort · Outcome twin
ORACLE Twin
Outcome prediction at 12 months for the SynCardia 70cc Total Artificial Heart.
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Patient at implant
Pre-implant clinical variables. Adjust to explore how outcomes shift.
Predicted outcomes at 12 months
Point estimates from an interpretable logistic model frozen at implant. Shaded band = ±1 indicative error margin.
Projected device success trajectory
A smoothed reference, not a per-month hazard curve — interpolated as success(t/12) from implant to the 12-month estimate.
What changes most?
Each lever re-scores the twin with one pre-implant factor altered, holding all else fixed. Δ is the change in modelled 12-month device success — associational, not causal.
Most similar historical patients
The 12 most similar historical patients and what happened to them.
Cohort summary
Device success at 12 months is the binary outcome: alive on device or transplanted versus on-device death. Cohort descriptors describe the analytic cohort. ORACLE uses the same outcome definitions as the companion manuscript on the larger N=637 cohort; the manuscript's stringent multivariable analysis uses an N=593 subset after exclusions.
Discrimination & calibration
| Outcome | c-statistic | Brier | n |
|---|
c-statistics are optimism-corrected via bootstrap (B=200). Temporal validation in a held-out era yielded c = 0.65 across all three outcomes, indicating stable performance over time without substantial evidence of overfitting.
Calibration — predicted vs observed
Device success over time — Aalen-Johansen estimator
Device success over 12 months, computed as 1 minus the Aalen-Johansen cumulative incidence of on-device death. Transplantation is treated as a competing event and is counted as device success at the time of transplant. This is the same outcome definition used in the companion manuscript on the larger N=637 cohort.
Frozen feature dictionary — 13 pre-implant variables
All variables are pre-implant. No post-implant information leaks into the predictor set. The dictionary is sealed in the engine artefact; any change requires a new model release.