METHODS: This retrospective and multinational cohort study included all adult transferred injury patients from Korea, Malaysia, Vietnam, and Taiwan between 2016 and 2018. The outcome of interest was a death in the emergency department (ED) after the patients' ED visit. Using these results, we developed the interpretable field triage score with the Korea registry using an interpretable machine learning framework and validated the score externally. The performance of each country's score was assessed using the area under the receiver operating characteristic curve (AUROC). Furthermore, a website for real-world application was developed using R Shiny.
FINDINGS: The study population included 26,294, 9404, 673 and 826 transferred injury patients between 2016 and 2018 from Korea, Malaysia, Vietnam, and Taiwan, respectively. The corresponding rates of a death in the ED were 0.30%, 0.60%, 4.0%, and 4.6% respectively. Age and vital sign were found to be the significant variables for predicting mortality. External validation showed the accuracy of the model with an AUROC of 0.756-0.850.
INTERPRETATION: The Grade for Interpretable Field Triage (GIFT) score is an interpretable and practical tool to predict mortality in field triage for trauma.
FUNDING: This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (Grant Number: HI19C1328).
METHODS: We conducted a large-scale, data-driven analysis on vaccine acceptance and actual uptake in eight Western Pacific countries before (2021) and after (2022) the mass COVID-19 vaccine rollouts. We compared vaccine acceptance or uptake rates between different subpopulations using Bootstrap methods and further constructed a logistic model to investigate the relationship between vaccine endorsement and diverse socio-demographic or trust-related determinants at these two time points.
FINDINGS: Substantial between-country differences in vaccine acceptance and uptake were observed across the Western Pacific, with Mongolia, Vietnam, Laos, Cambodia, and Malaysia being more pro-vaccine than the other three countries (Japan, South Korea, and the Philippines). Actual vaccination rates in 2022 were all higher than predicted from the 2021 responses. Influencers for vaccine endorsement were country-specific, but generally, groups susceptible to vaccine hesitancy included females, the less-educated, and those distrusting vaccines or health care providers.
INTERPRETATION: Our findings demonstrate the successful translation of vaccine intent to actual uptake with the deployment of COVID-19 vaccination in the Western Pacific. Increasing vaccine confidence and supressing dissemination of misinformation may play an essential role in reducing vaccine hesitancy and ramping up immunisation.
FUNDING: AIR@InnoHK.