Integrating Process-Based and Machine Learning Models for High Temporal-Resolution Algal Bloom Prediction in Rivers with Sparse Monitoring Data

Background and purpose — External validation of machine learning (ML) prediction models is an essential step before clinical application. We assessed the proportion, performance, and transparent reporting of externally validated ML prediction models in orthopedic surgery, using the Transparent Reporting for Individual Prognosis or Diagnosis (TRIPOD) guidelines. Material and methods — We performed a systematic search using synonyms for every orthopedic specialty, ML, and external validation. The proportion was determined by using 59 ML prediction models with only internal validation in orthopedic surgical outcome published up until June 18, 2020, previously identified by our group. Model performance was evaluated using discrimination, calibration, and decision-curve analysis. The TRIPOD guidelines assessed transparent reporting. Results — We included 18 studies externally validating 10 different ML prediction models of the 59 available ML models after screening 4,682 studies. All external validations identified in this review retained good discrimination. Other key performance measures were provided in only 3 studies, rendering overall performance evaluation difficult. The overall median TRIPOD completeness was 61% (IQR 43–89), with 6 items being reported in less than 4/18 of the studies. Interpretation — Most current predictive ML models are not externally validated. The 18 available external validation studies were characterized by incomplete reporting of performance measures, limiting a transparent examination of model performance. Further prospective studies are needed to validate or refute the myriad of predictive ML models in orthopedics while adhering to existing guidelines. This ensures clinicians can take full advantage of validated and clinically implementable ML decision tools.

Machine learning (ML) models provide more choices to patients with diabetes mellitus (DM) to more properly manage blood glucose (BG) levels. However, because of numerous types of ML algorithms, choosing an appropriate model is vitally important. In a systematic review and network meta-analysis, this study aimed to comprehensively assess the performance of ML models in predicting BG levels. In addition, we assessed ML models used to detect and predict adverse BG (hypoglycemia) events by calculating pooled estimates of sensitivity and specificity. PubMed, Embase, Web of Science, and Institute of Electrical and Electronics Engineers Explore databases were systematically searched for studies on predicting BG levels and predicting or detecting adverse BG events using ML models, from inception to November 2022. Studies that assessed the performance of different ML models in predicting or detecting BG levels or adverse BG events of patients with DM were included. Studies with no derivation or performance metrics of ML models were excluded. The Quality Assessment of Diagnostic Accuracy Studies tool was applied to assess the quality of included studies. Primary outcomes were the relative ranking of ML models for predicting BG levels in different prediction horizons (PHs) and pooled estimates of the sensitivity and specificity of ML models in detecting or predicting adverse BG events. In total, 46 eligible studies were included for meta-analysis. Regarding ML models for predicting BG levels, the means of the absolute root mean square error (RMSE) in a PH of 15, 30, 45, and 60 minutes were 18.88 (SD 19.71), 21.40 (SD 12.56), 21.27 (SD 5.17), and 30.01 (SD 7.23) mg/dL, respectively. The neural network model (NNM) showed the highest relative performance in different PHs. Furthermore, the pooled estimates of the positive likelihood ratio and the negative likelihood ratio of ML models were 8.3 (95% CI 5.7-12.0) and 0.31 (95% CI 0.22-0.44), respectively, for predicting hypoglycemia and 2.4 (95% CI 1.6-3.7) and 0.37 (95% CI 0.29-0.46), respectively, for detecting hypoglycemia. Statistically significant high heterogeneity was detected in all subgroups, with different sources of heterogeneity. For predicting precise BG levels, the RMSE increases with a rise in the PH, and the NNM shows the highest relative performance among all the ML models. Meanwhile, current ML models have sufficient ability to predict adverse BG events, while their ability to detect adverse BG events needs to be enhanced. PROSPERO CRD42022375250; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=375250.

Development and validation of an explainable machine learning model for mortality prediction among patients with infected pancreatic necrosis.

Recently, great progress has been achieved in diabetes management through minimally invasive continuous glucose monitoring, which involves piercing the skin to identify changes in glucose levels in the interstitial fluid. Nevertheless, the development of accurate fully noninvasive (NI) glucose monitors remains a topic of great interest. This work examines the processing of data collected from a multisensor system, which combines millimeter-wave (mm-wave), near-infrared (NIR), and other auxiliary sensors’ technology, coupled with a random forest machine learning (ML) model for prediction. We investigated possible correlations between mm-wave, NIR, skin temperature, pressure data, and blood glucose values and deployed an ML model for prediction. The model is based on the random forest algorithm that was trained and tested on data collected from a study involving five healthy human subjects undergoing an intravenous glucose tolerance test. Our model achieves a root mean square error of 21.06 mg/dl and a mean absolute relative difference of 7.31% for glucose prediction in the collected clinical subjects dataset. In addition, 96.1% of the model’s predictions fall within the clinically acceptable zones according to the Clarke error grid analysis. The preliminary results suggest that combining multiple sensor data with ML techniques is promising for the development of NI glucose monitoring.

PD27-01 DEVELOPMENT OF A MACHINE LEARNING (ML) MODEL TO AUTOMATICALLY AND PRECISELY IDENTIFY KIDNEY STONES FROM URETEROSCOPY VIDEO RECORDINGS

Understanding the Performance of Machine Learning Models to Predict Credit Default: A Novel Approach for Supervisory Evaluation

Development of machine learning models for prediction of antibody non-specificity.

Annual burned areas in the United States have increased twofold during the past decades. With more large fires resulting in more emissions of fine particulate matter, an accurate prediction of fire emissions is critical for quantifying the impacts of fires on air quality, human health, and climate. This study aims to construct a machine learning (ML) model with game-theory interpretation to predict monthly fire emissions over the contiguous US and to understand the controlling factors of fire emissions. By comparing the predicted fire PM2.5 emissions from the interpretable ML model with the Global Fire Emissions Database (GFED) observations and predictions from process-based models in the Fire Modeling Intercomparison Project (FireMIP), the ML model is also used to diagnose the process-based models to inform future development. Results show promising performance for the ML model, Community Land Model (CLM), and Joint UK Land Environment Simulator-Interactive Fire And Emission Algorithm For Natural Environments (JULES-INFERNO) in reproducing the spatial distributions, seasonality, and interannual variability of fire emissions over CONUS. Regional analysis shows that only the ML model and CLM simulate the realistic interannual variability of fire emissions for most of the subregions (r > 0.95 for ML and r = 0.14 ~ 0.70 for CLM), except for Mediterranean California, where all the models perform poorly (r = 0.74 for ML and r < 0.30 for the FireMIP models). Regarding seasonality, most models capture the peak emission in July over western US. However, all models except for the ML model fail to reproduce the bimodal peaks in July and October over Mediterranean California, which may be explained by the coarse spatial resolutions of the processed-based models or atmospheric forcing data or limitations in model parameterizations for capturing the effects of Santa Ana winds on fire activity. Furthermore, most models struggle to capture the spring peak in emissions in southeastern US, probably due to underrepresentation of human effects and the influences of winter dryness on fires in the models. As for extreme events, both the ML model and CLM successfully reproduce the frequency map of extreme emission occurrence but overestimate the number of months with extremely large fire emissions. Comparing the fire PM2.5 emissions from the interpretable ML model with process-based fire models highlights their strengths and uncertainties for regional analysis and prediction and provides useful insights on future directions for model improvements.

&lt;p&gt;Background: The prediction of aneurysm treatment outcomes can help to optimize the treatment strategies. Machine learning (ML) has shown positive results in many clinical areas. However, the development of such models requires expertise in ML, which is not an easy task for surgeons.&lt;/p&gt;&lt;p&gt;Objectives: The recently emerged automated machine learning (AutoML) has shown promise in making ML more accessible to non-computer experts. We aimed to evaluate the feasibility of applying AutoML to develop the ML models for treatment outcome prediction.&lt;/p&gt;&lt;p&gt;Methods: The patients with aneurysms treated by endovascular treatment were prospectively recruited from 2016 to 2020. Treatment was considered successful if angiographic complete occlusion was achieved at follow-up. A statistical prediction model was developed using multivariate logistic regression. In addition, two ML models were developed. One was developed manually and the other was developed by AutoML. Three models were compared based on their area under the precision-recall curve (AUPRC) and area under the receiver operating characteristic curve (AUROC).&lt;/p&gt;&lt;p&gt;Results: The aneurysm size, stent-assisted coiling (SAC), and posterior circulation were the three significant and independent variables associated with treatment outcome. The statistical model showed an AUPRC of 0.432 and AUROC of 0.745. The conventional manually trained ML model showed an improved AUPRC of 0.545 and AUROC of 0.781. The AutoML derived ML model showed the best performance with AUPRC of 0.632 and AUROC of 0.832, significantly better than the other two models.&lt;/p&gt;&lt;p&gt;Conclusions: This study demonstrated the feasibility of using AutoML to develop a high-quality ML model, which may outperform the statistical model and manually derived ML models. AutoML could be a useful tool that makes ML more accessible to the clinical researchers.&lt;/p&gt;

12074 Background: Skeletal-related events (SREs) are detrimental clinical events in bone metastasis from advanced cancer, defined by pathologic fracture, spinal cord compression, and inevitable surgical or radiational intervention to the bone. Given their negative impact on quality of life and prognosis and interpatient heterogeneity in the SRE risk, accurate identification of patients with high SRE risk is critical. Methods: The patient-level data from three randomized clinical trials that administered zoledronic acid (ZA) to patients with bone-metastatic breast cancer, castration-resistant prostate cancer (CRPC), and other types of cancer were analyzed. (N = 460, 452, and 315, respectively) Machine learning (ML) models to predict SREs within 18 months (breast cancer), 12 months (CRPC), and 9 months (other cancers) were developed based on more than 40 baseline clinical and laboratory data. Seven ML algorithms and five feature selection methods were utilized to develop multiple models. The ML model with the best performance was identified based on the F1 score and the area under the receiver operating characteristic curve (AUC-ROC) for each cancer type and interrogated for important features with Shapley additive explanations. Lastly, the ML models’ ability to stratify patients by the cumulative SRE risk was evaluated by calculating hazard ratio (HR) with Cox-proportional hazards models. Results: Among the multiple ML models developed with different algorithms and feature selection methods, the model developed utilizing the random forests algorithm and the Boruta method for selecting features demonstrated the best performance in all types of cancer (F1 0.70, 0.67, and 0.67, and AUC-ROC 0.72, 0.68, and 0.73 for breast cancer, CRPC, and other cancers, respectively). In the ML model for breast cancer, performance status (PS), history of SRE, serum alkaline phosphatase (ALP), history of anti-neoplastic surgery, radiation therapy, and pathologic fracture were included as important features. Serum ALP, albumin, sodium, Gleason scores, and geographic regions were shown to be relevant in the CRPC model. For other cancers, serum ALP, albumin, total protein, phosphorus, red blood cell count, white blood cell count, visceral metastases, and history of arthritis were incorporated in the ML model. The ML model prediction successfully stratified the patients for cumulative SRE risk in all three cohorts. (HR with 95% confidence interval: 2.43 [1.86 – 3.18], 1.92 [1.51 – 2.45], and 3.06 [2.29 – 4.09] for breast cancer, CRPC, and other types of cancer, respectively). Conclusions: ML models incorporating baseline clinical and laboratory data can identify patients with bone metastasis on ZA harboring a high SRE risk.

Improve clinical feature-based bladder cancer survival prediction models through integration with gene expression profiles and machine learning techniques

We aimed to evaluate the diagnostic performance of neuroimaging-based machine learning (ML) models for non-invasive prediction of H3K27M mutations in diffuse midline gliomas (DMG). Following PRISMA-DTA guidelines, we searched four databases up to May 2025 to identify eligible studies evaluating neuroimaging-based ML for predicting H3K27M mutations in DMG. Study quality was assessed using PROBAST+AI and GRADE. Bivariate random-effects models were used to pool sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). Sixteen studies were included, comprising 2,357 patients in internal validation cohorts and 1,792 patients in external validation cohorts. MRI-based ML models showed strong diagnostic performance in internal validation, with pooled sensitivity of 0.86 (95% CI: 0.79-0.91), specificity of 0.82 (95% CI: 0.75-0.87), and AUC of 0.91 (95% CI: 0.88-0.93). For PET/CT-based ML models, pooled sensitivity was 0.58 (95% CI: 0.44-0.71) and pooled specificity was 0.65 (95% CI: 0.46-0.81), with an AUC of 0.61 (95% CI: 0.57-0.66). MRI-based ML showed significantly higher sensitivity (Z = 3.71; P < 0.01) and AUC (Z = 11.42; P < 0.01) than PET/CT-based ML. Subgroup analysis indicated that MRI-based deep learning (DL) models outperformed conventional machine learning (cML) algorithms (P = 0.01). Models using DNA sequencing as the reference standard showed higher specificity than those using immunohistochemistry (P < 0.001). MRI-based ML demonstrates high accuracy and generalizability for non-invasive H3K27M prediction in DMG, seemingly outperforming current PET/CT-based ML. The adoption of DL architectures and DNA sequencing as the reference standard may further improve performance, supporting the clinical utility of MRI-based ML for molecular stratification. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1078673, identifier CRD420251078673.

Land Use/Land Cover (LU/LC) change is among the dominant driving factors that directly influence water balance by transforming hydrological responses. Consequently, a thorough comprehension of its impacts is imperative for sustainable water resource planning and development, notably in developing worlds such as Pakistan, where agriculture is a major livelihood. This research intends to assess the continuing changes in LU/LC and evaluate their probable repercussions on the hydrological regime of the Potohar Plateau. The maximum likelihood classification (MLC) algorithm for land use classification of the high-resolution satellite imageries, the Cellular-Automata Markov Chain Model (CA-MCM) for the projection of LU/LC maps, and the Soil and Water Assessment Tool (SWAT) in tandem with SWAT-CUP for hydrological modeling were employed in this research. The high-resolution climatic dataset (10 × 10 km) was used in SWAT. The LU/LC analysis revealed a continual propagation of agricultural and built-up lands at the detriment of forest and barren land during the last three decades, which is anticipated to continue in the future, too. Hydrological model calibrations and validations were performed on multi-basins, and the performance was evaluated using different statistical coefficients, e.g., the coefficient of determination (R2), Nash–Sutcliffe Efficiency (NSE), Kling–Gupta Efficiency (KGE), and Percent Bias (PBIAS). The results yielded that the model performed very well and demonstrated the model’s robustness in reproducing the flow regime. The water balance study revealed that the anticipated LU/LC changes are projected to decrease the mean annual surface runoff, water yield, and streamflow due to an increase in percolation, lateral flow, sub-surface flow, and evapotranspiration. More significant variations of the water balance components were observed at the sub-basin level, owing to the heterogeneous spatial distribution of LU/LC, than at the basin level. The outcome of this study will provide pragmatic details to legislative bodies to develop land and water management ameliorative strategies to harness hydrological changes sustainably.

Transfer learning enables prediction of steel corrosion in concrete under natural environments

BackgroundAcute coronary syndromes (ACS) are the leading cause of global death. Optimizing mortality risk prediction and early identification of high-risk patients is essential for developing targeted prevention strategies. Many researchers have built machine learning (ML) models to predict the mortality risk in ACS patients. Our meta-analysis aimed to evaluate the predictive value of various ML models in predicting death in ACS patients at different times.MethodsPubMed, Embase, Web of Science, and Cochrane Library were searched systematically from database establishment to March 12, 2022 for studies developing or validating at least one ML predictive model for death in ACS patients. We used PROBAST to assess the risk of bias in the reported predictive models and a random-effects model to assess the pooled C-index and accuracy of these models.ResultsFifty papers were included, involving 216 ML prediction models, 119 of which were externally validated. The combined C-index of the ML models in the validation cohort predicting the in-hospital mortality, 30-day mortality, 3- or 6-month mortality, and 1 year or above mortality in ACS patients were 0.8633 (95% CI 0.8467–0.8802), 0.8296 (95% CI 0.8134–0.8462), 0.8205 (95% CI 0.7881–0.8541), and 0.8197 (95% CI 0.8042–0.8354), respectively, with the corresponding combined accuracy of 0.8569 (95% CI 0.8411–0.8715), 0.8282 (95% CI 0.7922–0.8591), 0.7303 (95% CI 0.7184–0.7418), and 0.7837 (95% CI 0.7455–0.8175), indicating that the ML models were relatively excellent in predicting ACS mortality at different times. Furthermore, common predictors of death in ML models included age, sex, systolic blood pressure, serum creatinine, Killip class, heart rate, diastolic blood pressure, blood glucose, and hemoglobin.ConclusionsThe ML models had excellent predictive power for mortality in ACS, and the methodologies may need to be addressed before they can be used in clinical practice.