Literature DB >> 34143373

Explaining a model predicting quality of surgical practice: a first presentation to and review by clinical experts.

Arthur Derathé1, Fabian Reche1,2, Pierre Jannin3,4, Alexandre Moreau-Gaudry1,5, Bernard Gibaud3,4, Sandrine Voros6,7.   

Abstract

PURPOSE: Surgical Data Science (SDS) is an emerging research domain offering data-driven answers to challenges encountered by clinicians during training and practice. We previously developed a framework to assess quality of practice based on two aspects: exposure of the surgical scene (ESS) and the surgeon's profile of practice (SPP). Here, we wished to investigate the clinical relevance of the parameters learned by this model by (1) interpreting these parameters and identifying associated representative video samples and (2) presenting this information to surgeons in the form of a video-enhanced questionnaire. To our knowledge, this is the first approach in the field of SDS for laparoscopy linking the choices made by a machine learning model predicting surgical quality to clinical expertise.
METHOD: Spatial features and quality of practice scores extracted from labeled and segmented frames in 30 laparoscopic videos were used to predict the ESS and the SPP. The relationships between the inputs and outputs of the model were then analyzed and translated into meaningful sentences (statements, e.g., "To optimize the ESS, it is very important to correctly handle the spleen"). Representative video clips illustrating these statements were semi-automatically identified. Eleven statements and video clips were used in a survey presented to six experienced digestive surgeons to gather their opinions on the algorithmic analyses.
RESULTS: All but one of the surgeons agreed with the proposed questionnaire overall. On average, surgeons agreed with 7/11 statements.
CONCLUSION: This proof-of-concept study provides preliminary validation of our model which has a high potential for use to analyze and understand surgical practices.

Entities:  

Keywords:  Explainable artificial intelligence; Surgical skills; Video-based assessment

Year:  2021        PMID: 34143373     DOI: 10.1007/s11548-021-02422-0

Source DB:  PubMed          Journal:  Int J Comput Assist Radiol Surg        ISSN: 1861-6410            Impact factor:   2.924


  14 in total

1.  Continuous intraoperative neuromonitoring in thyroid surgery: Safety analysis of 400 consecutive electrode probe placements with standardized procedures.

Authors:  Alberto Mangano; Hoon Yub Kim; Chei-Wei Wu; Stefano Rausei; Sun Hui; Liu Xiaoli; Feng-Yu Chiang; Dimitrios H Roukos; Georgios D Lianos; Erivelto Volpi; Gianlorenzo Dionigi
Journal:  Head Neck       Date:  2015-11-28       Impact factor: 3.147

2.  A study of crowdsourced segment-level surgical skill assessment using pairwise rankings.

Authors:  Anand Malpani; S Swaroop Vedula; Chi Chiung Grace Chen; Gregory D Hager
Journal:  Int J Comput Assist Radiol Surg       Date:  2015-06-30       Impact factor: 2.924

3.  Surgical data science for next-generation interventions.

Authors:  Lena Maier-Hein; Swaroop S Vedula; Stefanie Speidel; Nassir Navab; Ron Kikinis; Adrian Park; Matthias Eisenmann; Hubertus Feussner; Germain Forestier; Stamatia Giannarou; Makoto Hashizume; Darko Katic; Hannes Kenngott; Michael Kranzfelder; Anand Malpani; Keno März; Thomas Neumuth; Nicolas Padoy; Carla Pugh; Nicolai Schoch; Danail Stoyanov; Russell Taylor; Martin Wagner; Gregory D Hager; Pierre Jannin
Journal:  Nat Biomed Eng       Date:  2017-09       Impact factor: 25.671

4.  Offline identification of surgical deviations in laparoscopic rectopexy.

Authors:  Arnaud Huaulmé; Pierre Jannin; Fabian Reche; Jean-Luc Faucheron; Alexandre Moreau-Gaudry; Sandrine Voros
Journal:  Artif Intell Med       Date:  2020-02-27       Impact factor: 5.326

5.  Blinded peer assessment of surgical skill is feasible and can predict complication rates: a step toward measuring surgical quality.

Authors:  Tarek Y El Ahmadieh; James Harrop; H Hunt Batjer; Daniel K Resnick; Bernard R Bendok
Journal:  Neurosurgery       Date:  2014-06       Impact factor: 4.654

6.  Predicting the quality of surgical exposure using spatial and procedural features from laparoscopic videos.

Authors:  Arthur Derathé; Fabian Reche; Alexandre Moreau-Gaudry; Pierre Jannin; Bernard Gibaud; Sandrine Voros
Journal:  Int J Comput Assist Radiol Surg       Date:  2019-10-31       Impact factor: 2.924

7.  Explainable Artificial Intelligence for Safe Intraoperative Decision Support.

Authors:  Lauren Gordon; Teodor Grantcharov; Frank Rudzicz
Journal:  JAMA Surg       Date:  2019-11-01       Impact factor: 14.766

8.  Fifth International Consensus Conference: current status of sleeve gastrectomy.

Authors:  Michel Gagner; Colleen Hutchinson; Raul Rosenthal
Journal:  Surg Obes Relat Dis       Date:  2016-01-25       Impact factor: 4.734

9.  Explainable machine-learning predictions for the prevention of hypoxaemia during surgery.

Authors:  Scott M Lundberg; Bala Nair; Monica S Vavilala; Mayumi Horibe; Michael J Eisses; Trevor Adams; David E Liston; Daniel King-Wai Low; Shu-Fang Newman; Jerry Kim; Su-In Lee
Journal:  Nat Biomed Eng       Date:  2018-10-10       Impact factor: 25.671

10.  Application of objective clinical human reliability analysis (OCHRA) in assessment of technical performance in laparoscopic rectal cancer surgery.

Authors:  J D Foster; D Miskovic; A S Allison; J A Conti; J Ockrim; E J Cooper; G B Hanna; N K Francis
Journal:  Tech Coloproctol       Date:  2016-05-06       Impact factor: 3.781

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