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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