INTRODUCTION: Reliable preoperative identification of patients at high risk for early postoperative complications occurring within 24 h (EPC) of intracranial tumor surgery can improve patient safety and postoperative management. Statistical analysis using machine learning algorithms may generate models that predict EPC better than conventional statistical methods. OBJECTIVE: To train such a model and to assess its predictive ability. METHODS: This cohort study included patients from an ongoing prospective patient registry at a single tertiary care center with an intracranial tumor that underwent elective neurosurgery between June 2015 and May 2017. EPC were categorized based on the Clavien-Dindo classification score. Conventional statistical methods and different machine learning algorithms were used to predict EPC using preoperatively available patient, clinical, and surgery-related variables. The performance of each model was derived from examining classification performance metrics on an out-of-sample test dataset. RESULTS: EPC occurred in 174 (26%) of 668 patients included in the analysis. Gradient boosting machine learning algorithms provided the model best predicting the probability of an EPC. The model scored an accuracy of 0.70 (confidence interval [CI] 0.59-0.79) with an area under the curve (AUC) of 0.73 and a sensitivity and specificity of 0.80 (CI 0.58-0.91) and 0.67 (CI 0.53-0.77) on the test set. The conventional statistical model showed inferior predictive power (test set: accuracy: 0.59 (CI 0.47-0.71); AUC: 0.64; sensitivity: 0.76 (CI 0.64-0.85); specificity: 0.53 (CI 0.41-0.64)). CONCLUSION: Using gradient boosting machine learning algorithms, it was possible to create a prediction model superior to conventional statistical methods. While conventional statistical methods favor patients' characteristics, we found the pathology and surgery-related (histology, anatomical localization, surgical access) variables to be better predictors of EPC.
INTRODUCTION: Reliable preoperative identification of patients at high risk for early postoperative complications occurring within 24 h (EPC) of intracranial tumor surgery can improve patient safety and postoperative management. Statistical analysis using machine learning algorithms may generate models that predict EPC better than conventional statistical methods. OBJECTIVE: To train such a model and to assess its predictive ability. METHODS: This cohort study included patients from an ongoing prospective patient registry at a single tertiary care center with an intracranial tumor that underwent elective neurosurgery between June 2015 and May 2017. EPC were categorized based on the Clavien-Dindo classification score. Conventional statistical methods and different machine learning algorithms were used to predict EPC using preoperatively available patient, clinical, and surgery-related variables. The performance of each model was derived from examining classification performance metrics on an out-of-sample test dataset. RESULTS: EPC occurred in 174 (26%) of 668 patients included in the analysis. Gradient boosting machine learning algorithms provided the model best predicting the probability of an EPC. The model scored an accuracy of 0.70 (confidence interval [CI] 0.59-0.79) with an area under the curve (AUC) of 0.73 and a sensitivity and specificity of 0.80 (CI 0.58-0.91) and 0.67 (CI 0.53-0.77) on the test set. The conventional statistical model showed inferior predictive power (test set: accuracy: 0.59 (CI 0.47-0.71); AUC: 0.64; sensitivity: 0.76 (CI 0.64-0.85); specificity: 0.53 (CI 0.41-0.64)). CONCLUSION: Using gradient boosting machine learning algorithms, it was possible to create a prediction model superior to conventional statistical methods. While conventional statistical methods favor patients' characteristics, we found the pathology and surgery-related (histology, anatomical localization, surgical access) variables to be better predictors of EPC.
Authors: Ayesha Quddusi; Hubert A J Eversdijk; Anita M Klukowska; Marlies P de Wispelaere; Julius M Kernbach; Marc L Schröder; Victor E Staartjes Journal: Eur Spine J Date: 2019-10-22 Impact factor: 3.134
Authors: Vittorio Stumpo; Victor E Staartjes; Giuseppe Esposito; Carlo Serra; Luca Regli; Alessandro Olivi; Carmelo Lucio Sturiale Journal: Acta Neurochir Suppl Date: 2022
Authors: Giovanna Brandi; Vittorio Stumpo; Marco Gilone; Lazar Tosic; Johannes Sarnthein; Victor E Staartjes; Sophie Shih-Yüng Wang; Bas Van Niftrik; Luca Regli; Emanuela Keller; Carlo Serra Journal: Medicine (Baltimore) Date: 2022-07-08 Impact factor: 1.817
Authors: Victor E Staartjes; Vittorio Stumpo; Julius M Kernbach; Anita M Klukowska; Pravesh S Gadjradj; Marc L Schröder; Anand Veeravagu; Martin N Stienen; Christiaan H B van Niftrik; Carlo Serra; Luca Regli Journal: Acta Neurochir (Wien) Date: 2020-08-18 Impact factor: 2.216