Challenges in developing and validating machine learning models for transcatheter aortic valve implantation mortality risk prediction

We read with interest the article by Leha et al.,1 developing and validating the TRIM risk scores for predicting the risk of 30-day mortality following transcatheter aortic valve implantation (TAVI) using machine learning (ML) models. We commend the authors for developing two models based on TAVI pre-procedural (TRIMpre) and post-procedural (TRIMpost) variables; however, we would like to raise some concerns and discuss potential methodological challenges that might have influenced the results.
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