Cervical cancer survival prediction by machine learning algorithms: a systematic review

The aging and multimorbid population and health personnel shortages pose a substantial burden on primary health care. While predictive machine learning (ML) algorithms have the potential to address these challenges, concerns include transparency and insufficient reporting of model validation and effectiveness of the implementation in the clinical workflow. To systematically identify predictive ML algorithms implemented in primary care from peer-reviewed literature and US Food and Drug Administration (FDA) and Conformité Européene (CE) registration databases and to ascertain the public availability of evidence, including peer-reviewed literature, gray literature, and technical reports across the artificial intelligence (AI) life cycle. PubMed, Embase, Web of Science, Cochrane Library, Emcare, Academic Search Premier, IEEE Xplore, ACM Digital Library, MathSciNet, AAAI.org (Association for the Advancement of Artificial Intelligence), arXiv, Epistemonikos, PsycINFO, and Google Scholar were searched for studies published between January 2000 and July 2023, with search terms that were related to AI, primary care, and implementation. The search extended to CE-marked or FDA-approved predictive ML algorithms obtained from relevant registration databases. Three reviewers gathered subsequent evidence involving strategies such as product searches, exploration of references, manufacturer website visits, and direct inquiries to authors and product owners. The extent to which the evidence for each predictive ML algorithm aligned with the Dutch AI predictive algorithm (AIPA) guideline requirements was assessed per AI life cycle phase, producing evidence availability scores. The systematic search identified 43 predictive ML algorithms, of which 25 were commercially available and CE-marked or FDA-approved. The predictive ML algorithms spanned multiple clinical domains, but most (27 [63%]) focused on cardiovascular diseases and diabetes. Most (35 [81%]) were published within the past 5 years. The availability of evidence varied across different phases of the predictive ML algorithm life cycle, with evidence being reported the least for phase 1 (preparation) and phase 5 (impact assessment) (19% and 30%, respectively). Twelve (28%) predictive ML algorithms achieved approximately half of their maximum individual evidence availability score. Overall, predictive ML algorithms from peer-reviewed literature showed higher evidence availability compared with those from FDA-approved or CE-marked databases (45% vs 29%). The findings indicate an urgent need to improve the availability of evidence regarding the predictive ML algorithms' quality criteria. Adopting the Dutch AIPA guideline could facilitate transparent and consistent reporting of the quality criteria that could foster trust among end users and facilitating large-scale implementation.

Category:Ankle Arthritis; AnkleIntroduction/Purpose:Ankle arthrodesis and total ankle replacement are the most commonly performed procedures for surgical management of ankle arthritis. Arthrodesis provides effective pain relief but the rate of complications after arthrodesis is higher as it is more commonly performed in patients with comorbidities that preclude ankle replacement. Accurately risk- stratifying patients who undergo ankle arthrodesis would be of great utility, given the significant cost and morbidity associated with developing major perioperative complications. There is a paucity of accurate prediction models that can be used to pre- operatively risk-stratify patients for ankle arthrodesis. We aim to develop a machine learning (ML) algorithm for prediction of major perioperative complication after ankle arthrodesis as well as compare its performance against traditional predictive models based on logistic regression.Methods:This is a retrospective cohort study of adult patients who underwent ankle arthrodesis at any non-federal California hospital between 2015 and 2017. The primary outcome was readmission within 30 days or major perioperative complication - venous thromboembolism within 30 days, myocardial infarction within 7 days, pneumonia within 7 days, systemic infection within 7 days, surgical site bleeding within 90 days, and wound complications within 90 days. We build ML and logistic regression models that span different classes of modeling approaches: XGBoost, AdaBoost, Gradient Boosting, and Random Forest. Discrimination and calibration were assessed using area under the receiver operating characteristic curve (AUROC) and Brier score, respectively. We utilize a partial dependence function to measure the importance of an individual feature by assessing the average effect in predicted risks when its value is altered. We rank the contribution of the included variables to the prediction of adverse outcomes.Results:A total of 1,084 patients met inclusion criteria for this study. There were 131 major complications or readmission (12.1%). The optimized XGBoost algorithm demonstrates higher discrimination (AUROC: 0.707 + 0.052) compared to LR (0.691 + 0.055). The receiver operating characteristic curves for the XGBoost and logistic regression models are visualized in Figure 1. XGBoost also outperforms the three other ML models. This model was well calibrated (Brier score: 0.103 + 0.001). The variables most important for the XGBoost model include diabetes, chronic kidney disease, implant complication, and major fracture. Five of the ten most important features for XGBoost were markedly less important for the traditional logistic regression model: male sex, prior hip fracture, cardiorespiratory failure, acute renal failure, and dialysis status.Conclusion:We report a ML algorithm for prediction of major perioperative complications after ankle arthrodesis. The optimized XGBoost model is well-calibrated and demonstrates superior risk prediction to logistic regression. This tool may identify and address potentially modifiable risk factors, helping to accurately risk-stratify patients and decrease likelihood of major complications. Notably, the predictors most important for XGBoost are different from those for logistic regression. This suggests that the superior discriminative capability of ML methods stems from their ability to capture complex non-linear relationships between variables that logistic regression is unable to detect.

P125. Development of a novel ensemble machine learning algorithm for prediction of complications and readmission after anterior cervical spinal fusion

Cervical cancer is a highly prevalent malignancy affecting women worldwide, ranking as the seventh most common cancer globally. This study aims to systematically review and analyze cervical cancer survival predictions using machine learning (ML) algorithms. A comprehensive search was conducted across Scopus and PubMed databases in February 2024. Extracted articles were screened using Hubmeta software, with duplicates and non-relevant studies excluded. The final selection, comprising 24 articles, focused on survival predictions through ML techniques. These studies, published mostly post-2019, included datasets ranging from 75 to 9,462 cervical cancer patients and up to 91,294 squamous cell samples. The most commonly applied ML models were Random Forest (RF), Neural Networks (NN), Support Vector Machines (SVM), Ensemble and Hybrid Learning, and Deep Learning (DL). The area under the curve (AUC) for these models ranged from 0.84 to 0.9875, demonstrating their strong predictive capabilities. Clinical patient records were the primary data source. Meta-analysis was performed on the extracted data using GraphPad Prism for descriptive statistics and One-Way ANOVA. No significant differences were found between group means, as evidenced by an R-squared value of 0.1459. This result indicates that the independent variable (year of study) explained only 14.59% of the variance in ML model performance. The study found that the use of ML models has increased over time, particularly with Convolutional Neural Networks (CNNs) such as the ResNet50 model, which demonstrated superior accuracy metrics, including over 90% accuracy for the ResNet152 variant. These findings suggest that integrating multi-dimensional data with ML models holds significant potential for improving survival predictions in cervical cancer patients. Future research is recommended to develop tailored ML algorithms with even higher predictive accuracy for cervical cancer survival.

This paper compares various machine learning algorithms for predicting availability and possible reorder level of military logistics. As a case scenario, dataset of price of petroleum product was used to test the accuracy of the proposed algorithm. In most Military, facilities, machines and equipment relied heavily on the availability of petroleum products. Military logistics must be intelligent, based on informed deductions. Machine learning is now pervasive and is readily applied to various areas of life including the military. Result of the evaluation shows that artificial neural network (ANN)- 85.57% and logistic regression- 78.44% performed better than k-nearest neighbour (KNN)-74.98%, random forest(RF)-72.81% and Naive Bayes(NB)-74.85%. If used in Military logistics, there could be attendant benefit such as: accurate price policy formulation; proper budgeting estimation; meeting production and demand targets; proactive supply chain and value chain derivations; informed and intelligent decision making process; competitive advantage and continuous availability of supply critical to military; trigger of further research on innovative emergent technologies in this area, amongst other intangible benefits.

P68. Machine learning algorithms for predicting patient-controlled analgesia use after minimally invasive spine surgery

Machine learning (ML) methods have shown great potential in predicting colorectal cancer (CRC) survival. However, the ML models introduced thus far have mainly focused on binary outcomes and have not considered the time-to-event nature of this type of modeling. This study aims to evaluate the performance of ML approaches for modeling time-to-event survival data and develop transparent models for predicting CRC-specific survival. The data set used in this retrospective cohort study contains information on patients who were newly diagnosed with CRC between December 28, 2012, and December 27, 2019, at West China Hospital, Sichuan University. We assessed the performance of 6 representative ML models, including random survival forest (RSF), gradient boosting machine (GBM), DeepSurv, DeepHit, neural net-extended time-dependent Cox (or Cox-Time), and neural multitask logistic regression (N-MTLR) in predicting CRC-specific survival. Multiple imputation by chained equations method was applied to handle missing values in variables. Multivariable analysis and clinical experience were used to select significant features associated with CRC survival. Model performance was evaluated in stratified 5-fold cross-validation repeated 5 times by using the time-dependent concordance index, integrated Brier score, calibration curves, and decision curves. The SHapley Additive exPlanations method was applied to calculate feature importance. A total of 2157 patients with CRC were included in this study. Among the 6 time-to-event ML models, the DeepHit model exhibited the best discriminative ability (time-dependent concordance index 0.789, 95% CI 0.779-0.799) and the RSF model produced better-calibrated survival estimates (integrated Brier score 0.096, 95% CI 0.094-0.099), but these are not statistically significant. Additionally, the RSF, GBM, DeepSurv, Cox-Time, and N-MTLR models have comparable predictive accuracy to the Cox Proportional Hazards model in terms of discrimination and calibration. The calibration curves showed that all the ML models exhibited good 5-year survival calibration. The decision curves for CRC-specific survival at 5 years showed that all the ML models, especially RSF, had higher net benefits than default strategies of treating all or no patients at a range of clinically reasonable risk thresholds. The SHapley Additive exPlanations method revealed that R0 resection, tumor-node-metastasis staging, and the number of positive lymph nodes were important factors for 5-year CRC-specific survival. This study showed the potential of applying time-to-event ML predictive algorithms to help predict CRC-specific survival. The RSF, GBM, Cox-Time, and N-MTLR algorithms could provide nonparametric alternatives to the Cox Proportional Hazards model in estimating the survival probability of patients with CRC. The transparent time-to-event ML models help clinicians to more accurately predict the survival rate for these patients and improve patient outcomes by enabling personalized treatment plans that are informed by explainable ML models.

Development of Machine Learning Algorithms for Prediction of Sustained Postoperative Opioid Prescriptions After Total Hip Arthroplasty

Background: Accurate diagnosis of Parkinson’s disease (PD) is challenging due to its diverse manifestations. Machine learning (ML) algorithms can improve diagnostic precision, but their generalizability across medical centers in China is underexplored. Objective: To assess the accuracy of an ML algorithm for PD diagnosis, trained and tested on data from different medical centers in China. Methods: A total of 1656 participants were included, with 1028 from Beijing (training set) and 628 from Fuzhou (external validation set). Models were trained using the least absolute shrinkage and selection operator–logistic regression (LASSO-LR), decision tree (DT), random forest (RF), eXtreme gradient boosting (XGboost), support vector machine (SVM), and k-nearest neighbor (KNN) techniques. Hyperparameters were optimized using five-fold cross-validation and grid search techniques. Model performance was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve, accuracy, sensitivity (recall), specificity, precision, and F1 score. Variable importance was assessed for all models. Results: SVM demonstrated the best differentiation between healthy controls (HCs) and PD patients (AUC: 0.928, 95% CI: 0.908–0.947; accuracy: 0.844, 95% CI: 0.814–0.871; sensitivity: 0.826, 95% CI: 0.786–0.866; specificity: 0.861, 95% CI: 0.820–0.898; precision: 0.849, 95% CI: 0.807–0.891; F1 score: 0.837, 95% CI: 0.803–0.868) in the validation set. Constipation, olfactory decline, and daytime somnolence significantly influenced predictability. Conclusion: We identified multiple pivotal variables and SVM as a precise and clinician-friendly ML algorithm for prediction of PD in Chinese patients.

Machine Learning Algorithm Prospectively Predicts Survival for High-Risk Patients Undergoing Radiotherapy: A Survival Analysis of SHIELD-RT

Development of a Machine Learning Algorithm for Prediction of Complications and Unplanned Readmission Following Reverse Total Shoulder Arthroplasty

Surface water pollution become a nuisance for humankind as river water fulfill requirement of a major population and traditional method of water quality assessment and evaluation is inadequate in this era. So using advance method of machine learning in prediction of surface water proves to be helpful to prevent future water accident. As we seen many recent studies of water quality prediction and river water assessment using machine learning approach for better accuracy and less labor and to optimize its overall results. It’s become essential to review the recent studies which used Machine Learning algorithms for prediction, analysis, evaluation and assessment of river water quality and different models used in these studies for different environmental conditions. Machine learning models are superior to handle such complex and non linear data such as water quality parameters with greater accuracy, reliability, cost-effectiveness and efficiency as considered as great tool for surface Water Quality monitoring, prediction, future projects and help lawmakers in policy. In this report we reviewed around 17 research papers which uses machine learning approach from different journal and concise it to covers the structure of study, datasets used, methodology analysis, models performance, environment susceptibility, comparative analysis and assessments of Machine Learning models progress in river water quality research. For better management and control of surface water quality and its treatment, this study will help in understanding and analyzing the studies reviewed in this paper and its future application. We can conclude that research on Water Quality prediction using Machine Learning model are inadequate in the context future vulnerability, observing increasing pollution in recent years we require more research in this field. Finally, this study provides breakthrough in Surface Water Engineering and Management to give a new direction to fore coming studies and fortified it scope also gives a comparative approach for its implementation in new studies.

Background: Application of Machine Learning (ML) techniques in the prediction of Neurological Disorders has been growing rapidly. ML techniques require novel computer programming skills along with domain knowledge to produce a useful tool. We used Google Auto ML and Google ML Tables, a Cloud based front-end tools to develop, validate and deploy a prognostic model for Intracerebral Hemorrhage (ICH) without a single line of programming code. Methods: Data from Kasturba Medical College (KMC) Hospital ICH Stroke Registry between January 2015 and May 2019 was accessed. Google Auto ML Tables splits the dataset into training, validation and testing sets. 80% of the dataset was used for training, 10% for validation, and 10% for testing. Cramers V correlation statistic ( ϕ c ) between 30 variables and outcome was used to select 20 variables to predict the dichotomous outcome of good (mRS 0-3) vs bad outcome (mRS 4-6). The ML model generated was evaluated using Area Under the Curve (AUC) and Receiver Operating Characteristic (ROC) measures and by confusion/error matrix. Logistic Regression model was developed in parallel using Wizard Pro with the same set of 20 variables. Results: 1000 patients from KMC Registry were analysed. Cramers V correlation was highest for Glasgow Coma Scale (GCS) on admission ( ϕ c =0.6), followed by hematoma volume ( ϕ c =0.57). The AUC ROC of the model for good and bad outcome was 0.89 with an accuracy of 85.6%. Confusion matrix predicted 84% patients with good outcome and 87% with poor outcome. Feature importance chart showed that GCS had the highest relative importance at 25.7, followed by hematoma volume and age. A similar model created with simple logistic regression yielded a ROC of 0.87 with comparable results to the machine learning platform. Conclusion: Useful ML models can be easily developed and implemented by clinicians possessing domain expertise using Google Auto ML without computer programming experience.

Aim: Machine learning (ML) and deep learning (DL) predictive models have been employed widely in clinical settings. Their potential support and aid to the clinician of providing an objective measure that can be shared among different centers enables the possibility of building more robust multicentric studies. This study aimed to propose a user-friendly and low-cost tool for COVID-19 mortality prediction using both an ML and a DL approach. Method: We enrolled 2348 patients from several hospitals in the Province of Reggio Emilia. Overall, 19 clinical features were provided by the Radiology Units of Azienda USL-IRCCS of Reggio Emilia, and 5892 radiomic features were extracted from each COVID-19 patient’s high-resolution computed tomography. We built and trained two classifiers to predict COVID-19 mortality: a machine learning algorithm, or support vector machine (SVM), and a deep learning model, or feedforward neural network (FNN). In order to evaluate the impact of the different feature sets on the final performance of the classifiers, we repeated the training session three times, first using only clinical features, then employing only radiomic features, and finally combining both information. Results: We obtained similar performances for both the machine learning and deep learning algorithms, with the best area under the receiver operating characteristic (ROC) curve, or AUC, obtained exploiting both clinical and radiomic information: 0.803 for the machine learning model and 0.864 for the deep learning model. Conclusions: Our work, performed on large and heterogeneous datasets (i.e., data from different CT scanners), confirms the results obtained in the recent literature. Such algorithms have the potential to be included in a clinical practice framework since they can not only be applied to COVID-19 mortality prediction but also to other classification problems such as diabetic prediction, asthma prediction, and cancer metastases prediction. Our study proves that the lesion’s inhomogeneity depicted by radiomic features combined with clinical information is relevant for COVID-19 mortality prediction.

Updated external validation of the SORG machine learning algorithms for prediction of ninety-day and one-year mortality after surgery for spinal metastasis