High-performance pediatric surgical risk calculator: A novel algorithm based on machine learning and pediatric NSQIP data.


Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
07 2023
Historique:
received: 23 08 2022
revised: 09 02 2023
accepted: 10 03 2023
medline: 21 6 2023
pubmed: 23 3 2023
entrez: 22 3 2023
Statut: ppublish

Résumé

New methods such as machine learning could provide accurate predictions with little statistical assumptions. We seek to develop prediction model of pediatric surgical complications based on pediatric National Surgical Quality Improvement Program(NSQIP). All 2012-2018 pediatric-NSQIP procedures were reviewed. Primary outcome was defined as 30-day post-operative morbidity/mortality. Morbidity was further classified as any, major and minor. Models were developed using 2012-2017 data. 2018 data was used as independent performance evaluation. 431,148 patients were included in the 2012-2017 training and 108,604 were included in the 2018 testing set. Our prediction models had high performance in mortality prediction at 0.94 AUC in testing set. Our models outperformed ACS-NSQIP Calculator in all categories for morbidity (0.90 AUC for major, 0.86 AUC for any, 0.69 AUC in minor complications). We developed a high-performing pediatric surgical risk prediction model. This powerful tool could potentially be used to improve the surgical care quality.

Sections du résumé

BACKGROUNDS
New methods such as machine learning could provide accurate predictions with little statistical assumptions. We seek to develop prediction model of pediatric surgical complications based on pediatric National Surgical Quality Improvement Program(NSQIP).
METHODS
All 2012-2018 pediatric-NSQIP procedures were reviewed. Primary outcome was defined as 30-day post-operative morbidity/mortality. Morbidity was further classified as any, major and minor. Models were developed using 2012-2017 data. 2018 data was used as independent performance evaluation.
RESULTS
431,148 patients were included in the 2012-2017 training and 108,604 were included in the 2018 testing set. Our prediction models had high performance in mortality prediction at 0.94 AUC in testing set. Our models outperformed ACS-NSQIP Calculator in all categories for morbidity (0.90 AUC for major, 0.86 AUC for any, 0.69 AUC in minor complications).
CONCLUSIONS
We developed a high-performing pediatric surgical risk prediction model. This powerful tool could potentially be used to improve the surgical care quality.

Identifiants

pubmed: 36948897
pii: S0002-9610(23)00106-X
doi: 10.1016/j.amjsurg.2023.03.009
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

115-121

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest No coauthors have any conflicts of interest to disclose.

Auteurs

Dimitris Bertsimas (D)

Operations Research Center, Massachusetts Institute of Technology, Cambridge, MA, USA.

Michael Li (M)

Operations Research Center, Massachusetts Institute of Technology, Cambridge, MA, USA.

Nova Zhang (N)

Operations Research Center, Massachusetts Institute of Technology, Cambridge, MA, USA.

Carlos Estrada (C)

Advanced Analytics Group of Pediatric Urology, Department of Urology, Boston Children's Hospital, Boston, MA, USA.

Hsin-Hsiao Scott Wang (HH)

Advanced Analytics Group of Pediatric Urology, Department of Urology, Boston Children's Hospital, Boston, MA, USA. Electronic address: scottwang3@gmail.com.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH