Development and Validation of the ALARN Model: A Predictive Mortality Score for Antisynthetase Syndrome
Authors' conclusion
The ALARN score incorporates five readily available clinical parameters and provides a simple, practical tool for predicting mortality risk in patients with ASyS.
Study context
- Population
- Patients with antisynthetase syndrome (ASyS) from three independent institutions in China
- Participants
- 1,194 patients3 institutions
- Exposure
- Derivation vs External
- Derivationn = 763
- Externaln = 431
- Outcome
- All-cause mortality
Methodological detailsprognostic model development and validation, multicentre, external validation, Cox proportional hazards, random survival forest
- Prognostic model development and validation
- Multicentre
- External validation
- Cox proportional hazards
- Random survival forest
Main finding
As reported in the abstract
ALARN model discrimination for mortality (time-dependent AUC)
Time-dependent AUC, 1-year mortality
0.914
95% CI 0.866–0.955
Time-dependent AUC, 3-year mortality
0.867
95% CI 0.829–0.906
Time-dependent AUC, 5-year mortality
0.839
95% CI 0.789–0.885
Time-dependent AUC, 10-year mortality
0.854
95% CI 0.789–0.909
Observational data: associations, not effects.
Further findings
Risk stratification: low- (ALARN 0-2), intermediate- (3-5), high-risk (6-8)
- Significantly different survival outcomes across risk groups
- log-rank P < 0.0001
Cox proportional hazards (CPH) vs random survival forest (RSF) model performance
- CPH model better performance than RSF model in internal validation cohort
Original publication
Development and Validation of the ALARN Model: A Predictive Mortality Score for Antisynthetase Syndrome. Arthritis Rheumatol. Published 9 June 2026. doi:10.
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