scholarly journals Prediction Model of Osteonecrosis of the Femoral Head After Femoral Neck Fracture: Machine Learning–Based Development and Validation Study (Preprint)

2021 ◽  
Author(s):  
Huan Wang ◽  
Wei Wu ◽  
Chunxia Han ◽  
Jiaqi Zheng ◽  
Xinyu Cai ◽  
...  

BACKGROUND The absolute number of femoral neck fractures (FNFs) is increasing; however, the prediction of traumatic femoral head necrosis remains difficult. Machine learning algorithms have the potential to be superior to traditional prediction methods for the prediction of traumatic femoral head necrosis. OBJECTIVE The aim of this study is to use machine learning to construct a model for the analysis of risk factors and prediction of osteonecrosis of the femoral head (ONFH) in patients with FNF after internal fixation. METHODS We retrospectively collected preoperative, intraoperative, and postoperative clinical data of patients with FNF in 4 hospitals in Shanghai and followed up the patients for more than 2.5 years. A total of 259 patients with 43 variables were included in the study. The data were randomly divided into a training set (181/259, 69.8%) and a validation set (78/259, 30.1%). External data (n=376) were obtained from a retrospective cohort study of patients with FNF in 3 other hospitals. Least absolute shrinkage and selection operator regression and the support vector machine algorithm were used for variable selection. Logistic regression, random forest, support vector machine, and eXtreme Gradient Boosting (XGBoost) were used to develop the model on the training set. The validation set was used to tune the model hyperparameters to determine the final prediction model, and the external data were used to compare and evaluate the model performance. We compared the accuracy, discrimination, and calibration of the models to identify the best machine learning algorithm for predicting ONFH. Shapley additive explanations and local interpretable model-agnostic explanations were used to determine the interpretability of the black box model. RESULTS A total of 11 variables were selected for the models. The XGBoost model performed best on the validation set and external data. The accuracy, sensitivity, and area under the receiver operating characteristic curve of the model on the validation set were 0.987, 0.929, and 0.992, respectively. The accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve of the model on the external data were 0.907, 0.807, 0.935, and 0.933, respectively, and the log-loss was 0.279. The calibration curve demonstrated good agreement between the predicted probability and actual risk. The interpretability of the features and individual predictions were realized using the Shapley additive explanations and local interpretable model-agnostic explanations algorithms. In addition, the XGBoost model was translated into a self-made web-based risk calculator to estimate an individual’s probability of ONFH. CONCLUSIONS Machine learning performs well in predicting ONFH after internal fixation of FNF. The 6-variable XGBoost model predicted the risk of ONFH well and had good generalization ability on the external data, which can be used for the clinical prediction of ONFH after internal fixation of FNF.

2018 ◽  
Vol 26 (1) ◽  
pp. 141-155 ◽  
Author(s):  
Li Luo ◽  
Fengyi Zhang ◽  
Yao Yao ◽  
RenRong Gong ◽  
Martina Fu ◽  
...  

Surgery cancellations waste scarce operative resources and hinder patients’ access to operative services. In this study, the Wilcoxon and chi-square tests were used for predictor selection, and three machine learning models – random forest, support vector machine, and XGBoost – were used for the identification of surgeries with high risks of cancellation. The optimal performances of the identification models were as follows: sensitivity − 0.615; specificity − 0.957; positive predictive value − 0.454; negative predictive value − 0.904; accuracy − 0.647; and area under the receiver operating characteristic curve − 0.682. Of the three models, the random forest model achieved the best performance. Thus, the effective identification of surgeries with high risks of cancellation is feasible with stable performance. Models and sampling methods significantly affect the performance of identification. This study is a new application of machine learning for the identification of surgeries with high risks of cancellation and facilitation of surgery resource management.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10884
Author(s):  
Xin Yu ◽  
Qian Yang ◽  
Dong Wang ◽  
Zhaoyang Li ◽  
Nianhang Chen ◽  
...  

Applying the knowledge that methyltransferases and demethylases can modify adjacent cytosine-phosphorothioate-guanine (CpG) sites in the same DNA strand, we found that combining multiple CpGs into a single block may improve cancer diagnosis. However, survival prediction remains a challenge. In this study, we developed a pipeline named “stacked ensemble of machine learning models for methylation-correlated blocks” (EnMCB) that combined Cox regression, support vector regression (SVR), and elastic-net models to construct signatures based on DNA methylation-correlated blocks for lung adenocarcinoma (LUAD) survival prediction. We used methylation profiles from the Cancer Genome Atlas (TCGA) as the training set, and profiles from the Gene Expression Omnibus (GEO) as validation and testing sets. First, we partitioned the genome into blocks of tightly co-methylated CpG sites, which we termed methylation-correlated blocks (MCBs). After partitioning and feature selection, we observed different diagnostic capacities for predicting patient survival across the models. We combined the multiple models into a single stacking ensemble model. The stacking ensemble model based on the top-ranked block had the area under the receiver operating characteristic curve of 0.622 in the TCGA training set, 0.773 in the validation set, and 0.698 in the testing set. When stratified by clinicopathological risk factors, the risk score predicted by the top-ranked MCB was an independent prognostic factor. Our results showed that our pipeline was a reliable tool that may facilitate MCB selection and survival prediction.


2021 ◽  
Vol 10 ◽  
Author(s):  
Mou Li ◽  
Ling Yang ◽  
Yufeng Yue ◽  
Jingxu Xu ◽  
Chencui Huang ◽  
...  

ObjectiveTo investigate whether a radiomics model can help to improve the performance of PI-RADS v2.1 in prostate cancer (PCa).MethodsThis was a retrospective analysis of 203 patients with pathologically confirmed PCa or non-PCa between March 2015 and December 2016. Patients were divided into a training set (n = 141) and a validation set (n = 62). The radiomics model (Rad-score) was developed based on multi-parametric MRI including T2 weighted imaging (T2WI), diffusion weighted imaging (DWI), apparent diffusion coefficient (ADC) imaging, and dynamic contrast enhanced (DCE) imaging. The combined model involving Rad-score and PI-RADS was compared with PI-RADS for the diagnosis of PCa by using the receiver operating characteristic curve (ROC) analysis.ResultsA total of 112 (55.2%) patients had PCa, and 91 (44.8%) patients had benign lesions. For PCa versus non-PCa, the Rad-score had a significantly higher area under the ROC curve (AUC) [0.979 (95% CI, 0.940–0.996)] than PI-RADS [0.905 (0.844–0.948), P = 0.002] in the training set. However, the AUC between them was insignificant in the validation set [0.861 (0.749–0.936) vs. 0.845 (0.731–0.924), P = 0.825]. When Rad-score was added to PI-RADS, the performance of the PI-RADS was significantly improved for the PCa diagnosis (AUC = 0.989, P < 0.001 for the training set and AUC = 0.931, P = 0.038 for the validation set).ConclusionsThe radiomics based on multi-parametric MRI can help to improve the diagnostic performance of PI-RADS v2.1 in PCa.


Author(s):  
František Sabovčik ◽  
Nicholas Cauwenberghs ◽  
Dmitry Kouznetsov ◽  
Francois Haddad ◽  
Amparo Alonso-Betanzos ◽  
...  

Abstract Aims  Both left ventricular (LV) diastolic dysfunction (LVDD) and hypertrophy (LVH) as assessed by echocardiography are independent prognostic markers of future cardiovascular events in the community. However, selective screening strategies to identify individuals at risk who would benefit most from cardiac phenotyping are lacking. We, therefore, assessed the utility of several machine learning (ML) classifiers built on routinely measured clinical, biochemical, and electrocardiographic features for detecting subclinical LV abnormalities. Methods and results  We included 1407 participants (mean age, 51 years, 51% women) randomly recruited from the general population. We used echocardiographic parameters reflecting LV diastolic function and structure to define LV abnormalities (LVDD, n = 252; LVH, n = 272). Next, four supervised ML algorithms (XGBoost, AdaBoost, Random Forest (RF), Support Vector Machines, and Logistic regression) were used to build classifiers based on clinical data (67 features) to categorize LVDD and LVH. We applied a nested 10-fold cross-validation set-up. XGBoost and RF classifiers exhibited a high area under the receiver operating characteristic curve with values between 86.2% and 88.1% for predicting LVDD and between 77.7% and 78.5% for predicting LVH. Age, body mass index, different components of blood pressure, history of hypertension, antihypertensive treatment, and various electrocardiographic variables were the top selected features for predicting LVDD and LVH. Conclusion  XGBoost and RF classifiers combining routinely measured clinical, laboratory, and electrocardiographic data predicted LVDD and LVH with high accuracy. These ML classifiers might be useful to pre-select individuals in whom further echocardiographic examination, monitoring, and preventive measures are warranted.


2020 ◽  
Vol 12 (18) ◽  
pp. 3104
Author(s):  
Gangqiang An ◽  
Minfeng Xing ◽  
Binbin He ◽  
Chunhua Liao ◽  
Xiaodong Huang ◽  
...  

Chlorophyll is an essential pigment for photosynthesis in crops, and leaf chlorophyll content can be used as an indicator for crop growth status and help guide nitrogen fertilizer applications. Estimating crop chlorophyll content plays an important role in precision agriculture. In this study, a variable, rate of change in reflectance between wavelengths ‘a’ and ‘b’ (RCRWa-b), derived from in situ hyperspectral remote sensing data combined with four advanced machine learning techniques, Gaussian process regression (GPR), random forest regression (RFR), support vector regression (SVR), and gradient boosting regression tree (GBRT), were used to estimate the chlorophyll content (measured by a portable soil–plant analysis development meter) of rice. The performances of the four machine learning models were assessed and compared using root mean square error (RMSE), mean absolute error (MAE), and coefficient of determination (R2). The results revealed that four features of RCRWa-b, RCRW551.0–565.6, RCRW739.5–743.5, RCRW684.4–687.1 and RCRW667.9–672.0, were effective in estimating the chlorophyll content of rice, and the RFR model generated the highest prediction accuracy (training set: RMSE = 1.54, MAE =1.23 and R2 = 0.95; validation set: RMSE = 2.64, MAE = 1.99 and R2 = 0.80). The GPR model was found to have the strongest generalization (training set: RMSE = 2.83, MAE = 2.16 and R2 = 0.77; validation set: RMSE = 2.97, MAE = 2.30 and R2 = 0.76). We conclude that RCRWa-b is a useful variable to estimate chlorophyll content of rice, and RFR and GPR are powerful machine learning algorithms for estimating the chlorophyll content of rice.


2021 ◽  
Vol 62 (03) ◽  
pp. e180-e192
Author(s):  
Claudio Díaz-Ledezma ◽  
David Díaz-Solís ◽  
Raúl Muñoz-Reyes ◽  
Jonathan Torres Castro

Resumen Introducción La predicción de la estadía hospitalaria luego de una artroplastia total de cadera (ATC) electiva es crucial en la evaluación perioperatoria de los pacientes, con un rol determinante desde el punto de vista operacional y económico. Internacionalmente, se han empleado macrodatos (big data, en inglés) e inteligencia artificial para llevar a cabo evaluaciones pronósticas de este tipo. El objetivo del presente estudio es desarrollar y validar, con el empleo del aprendizaje de máquinas (machine learning, en inglés), una herramienta capaz de predecir la estadía hospitalaria de pacientes chilenos mayores de 65 años sometidos a ATC por artrosis. Material y Métodos Empleando los registros electrónicos de egresos hospitalarios anonimizados del Departamento de Estadísticas e Información de Salud (DEIS), se obtuvieron los datos de 8.970 egresos hospitalarios de pacientes sometidos a ATC por artrosis entre los años 2016 y 2018. En total, 15 variables disponibles en el DEIS, además del porcentaje de pobreza de la comuna de origen del paciente, fueron incluidos para predecir la probabilidad de que un paciente presentara una estadía acortada (< 3 días) o prolongada (> 3 días) luego de la cirugía. Utilizando técnicas de aprendizaje de máquinas, 8 algoritmos de predicción fueron entrenados con el 80% de la muestra. El 20% restante se empleó para validar las capacidades predictivas de los modelos creados a partir de los algoritmos. La métrica de optimización se evaluó y ordenó en un ranking utilizando el área bajo la curva de característica operativa del receptor (area under the receiver operating characteristic curve, AUC-ROC, en inglés), que corresponde a cuan bien un modelo puede distinguir entre dos grupos. Resultados El algoritmo XGBoost obtuvo el mejor desempeño, con una AUC-ROC promedio de 0,86 (desviación estándar [DE]: 0,0087). En segundo lugar, observamos que el algoritmo lineal de máquina de vector de soporte (support vector machine, SVM, en inglés) obtuvo una AUC-ROC de 0,85 (DE: 0,0086). La importancia relativa de las variables explicativas demostró que la región de residencia, el servicio de salud, el establecimiento de salud donde se operó el paciente, y la modalidad de atención son las variables que más determinan el tiempo de estadía de un paciente. Discusión El presente estudio desarrolló algoritmos de aprendizaje de máquinas basados en macrodatos chilenos de libre acceso, y logró desarrollar y validar una herramienta que demuestra una adecuada capacidad discriminatoria para predecir la probabilidad de estadía hospitalaria acortada versus prolongada en adultos mayores sometidos a ATC por artrosis. Conclusión Los algoritmos creados a traves del empleo del aprendizaje de máquinas permiten predecir la estadía hospitalaria en pacientes chilenos operado de artroplastia total de cadera electiva.


2021 ◽  
Vol 11 ◽  
Author(s):  
Zenghui Qian ◽  
Lingling Zhang ◽  
Jie Hu ◽  
Shuguang Chen ◽  
Hongyan Chen ◽  
...  

ObjectiveTo identify optimal machine-learning methods for the radiomics-based differentiation of gliosarcoma (GSM) from glioblastoma (GBM).Materials and MethodsThis retrospective study analyzed cerebral magnetic resonance imaging (MRI) data of 83 patients with pathologically diagnosed GSM (58 men, 25 women; mean age, 50.5 ± 12.9 years; range, 16-77 years) and 100 patients with GBM (58 men, 42 women; mean age, 53.4 ± 14.1 years; range, 12-77 years) and divided them into a training and validation set randomly. Radiomics features were extracted from the tumor mass and peritumoral edema. Three feature selection and classification methods were evaluated in terms of their performance in distinguishing GSM and GBM: the least absolute shrinkage and selection operator (LASSO), Relief, and Random Forest (RF); and adaboost classifier (Ada), support vector machine (SVM), and RF; respectively. The area under the receiver operating characteristic curve (AUC) and accuracy (ACC) of each method were analyzed.ResultsBased on tumor mass features, the selection method LASSO + classifier SVM was found to feature the highest AUC (0.85) and ACC (0.77) in the validation set, followed by Relief + RF (AUC = 0.84, ACC = 0.72) and LASSO + RF (AUC = 0.82, ACC = 0.75). Based on peritumoral edema features, Relief + SVM was found to have the highest AUC (0.78) and ACC (0.73) in the validation set. Regardless of the method, tumor mass features significantly outperformed peritumoral edema features in the differentiation of GSM from GBM (P &lt; 0.05). Furthermore, the sensitivity, specificity, and accuracy of the best radiomics model were superior to those obtained by the neuroradiologists.ConclusionOur radiomics study identified the selection method LASSO combined with the classifier SVM as the optimal method for differentiating GSM from GBM based on tumor mass features.


2021 ◽  
Vol 27 (3) ◽  
pp. 189-199
Author(s):  
Ilias Tougui ◽  
Abdelilah Jilbab ◽  
Jamal El Mhamdi

Objectives: With advances in data availability and computing capabilities, artificial intelligence and machine learning technologies have evolved rapidly in recent years. Researchers have taken advantage of these developments in healthcare informatics and created reliable tools to predict or classify diseases using machine learning-based algorithms. To correctly quantify the performance of those algorithms, the standard approach is to use cross-validation, where the algorithm is trained on a training set, and its performance is measured on a validation set. Both datasets should be subject-independent to simulate the expected behavior of a clinical study. This study compares two cross-validation strategies, the subject-wise and the record-wise techniques; the subject-wise strategy correctly mimics the process of a clinical study, while the record-wise strategy does not.Methods: We started by creating a dataset of smartphone audio recordings of subjects diagnosed with and without Parkinson’s disease. This dataset was then divided into training and holdout sets using subject-wise and the record-wise divisions. The training set was used to measure the performance of two classifiers (support vector machine and random forest) to compare six cross-validation techniques that simulated either the subject-wise process or the record-wise process. The holdout set was used to calculate the true error of the classifiers.Results: The record-wise division and the record-wise cross-validation techniques overestimated the performance of the classifiers and underestimated the classification error.Conclusions: In a diagnostic scenario, the subject-wise technique is the proper way of estimating a model’s performance, and record-wise techniques should be avoided.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiawei Li ◽  
Litao Yang ◽  
Zheping Yuan ◽  
Jianyao Lou ◽  
Yiqun Fan ◽  
...  

Abstract Background Surgical resection is the only potentially curative treatment for pancreatic ductal adenocarcinoma (PDAC) and the survival of patients after radical resection is closely related to relapse. We aimed to develop models to predict the risk of relapse using machine learning methods based on multiple clinical parameters. Methods Data were collected and analysed of 262 PDAC patients who underwent radical resection at 3 institutions between 2013 and 2017, with 183 from one institution as a training set, 79 from the other 2 institution as a validation set. We developed and compared several predictive models to predict 1- and 2-year relapse risk using machine learning approaches. Results Machine learning techniques were superior to conventional regression-based analyses in predicting risk of relapse of PDAC after radical resection. Among them, the random forest (RF) outperformed other methods in the training set. The highest accuracy and area under the receiver operating characteristic curve (AUROC) for predicting 1-year relapse risk with RF were 78.4% and 0.834, respectively, and for 2-year relapse risk were 95.1% and 0.998. However, the support vector machine (SVM) model showed better performance than the others for predicting 1-year relapse risk in the validation set. And the k neighbor algorithm (KNN) model achieved the highest accuracy and AUROC for predicting 2-year relapse risk. Conclusions By machine learning, this study has developed and validated comprehensive models integrating clinicopathological characteristics to predict the relapse risk of PDAC after radical resection which will guide the development of personalized surveillance programs after surgery.


2021 ◽  
pp. 746-757
Author(s):  
Rajesh P. Shah ◽  
Heather M. Selby ◽  
Pritam Mukherjee ◽  
Shefali Verma ◽  
Peiyi Xie ◽  
...  

PURPOSE Small-cell lung cancer (SCLC) is the deadliest form of lung cancer, partly because of its short doubling time. Delays in imaging identification and diagnosis of nodules create a risk for stage migration. The purpose of our study was to determine if a machine learning radiomics model can detect SCLC on computed tomography (CT) among all nodules at least 1 cm in size. MATERIALS AND METHODS Computed tomography scans from a single institution were selected and resampled to 1 × 1 × 1 mm. Studies were divided into SCLC and other scans comprising benign, adenocarcinoma, and squamous cell carcinoma that were segregated into group A (noncontrast scans) and group B (contrast-enhanced scans). Four machine learning classification models, support vector classifier, random forest (RF), XGBoost, and logistic regression, were used to generate radiomic models using 59 quantitative first-order and texture Imaging Biomarker Standardization Initiative compliant PyRadiomics features, which were found to be robust between two segmenters with minimum Redundancy Maximum Relevance feature selection within each leave-one-out-cross-validation to avoid overfitting. The performance was evaluated using a receiver operating characteristic curve. A final model was created using the RF classifier and aggregate minimum Redundancy Maximum Relevance to determine feature importance. RESULTS A total of 103 studies were included in the analysis. The area under the receiver operating characteristic curve for RF, support vector classifier, XGBoost, and logistic regression was 0.81, 0.77, 0.84, and 0.84 in group A, and 0.88, 0.87, 0.85, and 0.81 in group B, respectively. Nine radiomic features in group A and 14 radiomic features in group B were predictive of SCLC. Six radiomic features overlapped between groups A and B. CONCLUSION A machine learning radiomics model may help differentiate SCLC from other lung lesions.


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