A method, a computing system and a computer program product are provided. A model is generated and trained. The model is based on clinical data with outcomes from clinically-defined hierarchical metadata in a selected level of clinically-defined hierarchical metadata serving as an initial set of prediction targets. A score is determined for each of the prediction targets based on the generated model and the set of evaluation factors. The set of prediction targets, the generated model, and the scores for the set of prediction targets are updated until the updated scores for the updated set of prediction targets satisfy acceptance criteria. The updated generated model, using the updated set of prediction targets, is applied to predict one of a set of updated prediction targets of mutually exclusive outcome categories.