OPTIMIZATION OF SCREENING PROTOCOLS FOR CERVICAL CANCER USING MACHINE LEARNING ALGORITHMS: A SYSTEMATIC REVIEW AND META-ANALYSIS

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.

Optimizing asphalt mix design through predicting effective asphalt content and absorbed asphalt content using machine learning

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

BackgroundDespite the interest in machine learning (ML) algorithms for analyzing real-world data (RWD) in healthcare, the use of ML in predicting time-to-event data, a common scenario in clinical practice, is less explored. ML models are capable of algorithmically learning from large, complex datasets and can offer advantages in predicting time-to-event data. We reviewed the recent applications of ML for survival analysis using RWD in healthcare.MethodsPUBMED and EMBASE were searched from database inception through March 2023 to identify peer-reviewed English-language studies of ML models for predicting time-to-event outcomes using the RWD. Two reviewers extracted information on the data source, patient population, survival outcome, ML algorithms, and the Area Under the Curve (AUC).ResultsOf 257 citations, 28 publications were included. Random survival forests (N = 16, 57%) and neural networks (N = 11, 39%) were the most popular ML algorithms. There was variability across AUC for these ML models (median 0.789, range 0.6–0.950). ML algorithms were predominately considered for predicting overall survival in oncology (N = 12, 43%). ML survival models were often used to predict disease prognosis or clinical events (N = 27, 96%) in the oncology, while less were used for treatment outcomes (N = 1, 4%).ConclusionsThe ML algorithms, random survival forests and neural networks, are mainly used for RWD to predict survival outcomes such as disease prognosis or clinical events in the oncology. This review shows that more opportunities remain to apply these ML algorithms to inform treatment decision-making in clinical practice. More methodological work is also needed to ensure the utility and applicability of ML models in survival outcomes.

The purpose of this analysis is to assess the use of machine learning (ML) algorithms in the prediction of postoperative outcomes, including complications, recurrence, and death in transsphenoidal surgery. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed all papers that used at least one ML algorithm to predict outcomes after transsphenoidal surgery. We searched Scopus, PubMed, and Web of Science databases for studies published prior to May 12, 2021. We identified 13 studies enrolling 5,048 patients. We extracted the general characteristics of each study; the sensitivity, specificity, area under the curve (AUC) of the ML models developed as well as the features identified as important by the ML models. We identified 12 studies with 5,048 patients that included ML algorithms for adenomas, three with 1807 patients specifically for acromegaly, and five with 2105 patients specifically for Cushing's disease. Nearly all were single-institution studies. The studies used a heterogeneous mix of ML algorithms and features to build predictive models. All papers reported an AUC greater than 0.7, which indicates clinical utility. ML algorithms have the potential to predict postoperative outcomes of transsphenoidal surgery and can improve patient care. Ensemble algorithms and neural networks were often top performers when compared with other ML algorithms. Biochemical and preoperative features were most likely to be selected as important by ML models. Inexplicability remains a challenge, but algorithms such as local interpretable model–agnostic explanation or Shapley value can increase explainability of ML algorithms. Our analysis shows that ML algorithms have the potential to greatly assist surgeons in clinical decision making.

Integrating machine learning (ML) models into healthcare systems is a rapidly evolving field with the potential to revolutionize care delivery. This study aimed to classify fertility rates and identify significant predictors using ML models among reproductive women in Ethiopia. This study utilized eight ML models in 5864 reproductive-age women using Ethiopian Demographic Health Survey (EDHS), 2019 data. Phyton programming language was used to develop these models. Predictors of fertility rate were determined using the feature important techniques. The performance of models was evaluated using accuracy, area under the curve (AUC), precision, recall, F1-score, specificity, and sensitivity. The mean age of participants was 32.7 (± 5.6) years. The random forest classifier (accuracy = 0.901 and AUC = 0.961) followed by a one-dimensional convolutional neural network (accuracy = 0.899 and AUC = 0.958), logistic regression (accuracy = 0.874 and AUC = 0.937), and gradient boost classifier (accuracy = 0.851 and AUC 0.927) were the top performing ML models. Family size, age, occupation, and education with an average importance score of 0.198, 0.151, 0.118, and 0.081, respectively were the top significant predictors of the fertility rate. The best ML models to classify and predict fertility rates were random forest, one-dimensional convolutional neural network, logistic regression, and gradient boost classifier. The findings on important factors of fertility rate can inform targeted public health, programs that address disparities related to family size, occupation, education, and other socioeconomic factors.

MP07-06 EVALUATING THE EFFICACY OF ARTIFICIAL INTELLIGENCE IN PREDICTING OUTCOMES FOR PEDIATRIC HYDRONEPHROSIS: A SYSTEMATIC REVIEW

Introduction Spine trauma represents a major cause of disability and substantial healthcare costs. Despite classification systems and risk scores, outcome prediction following spine trauma remains challenging. Machine learning (ML) approaches offer multidimensionality but vary widely in methodology, performance, and clinical application. This systematic review aims to characterize the use of ML for outcome prediction and prognostication in spine trauma. Methods A systematic search of PubMed, Embase, Scopus, Web of Science, and Cochrane Library was performed for publications from January 2015 to May 2025. Studies reporting ML for predicting clinical outcomes in spine trauma patients were identified using pre-defined criteria. Primary outcomes were types and performance metrics of ML models for spine trauma prognostication. Secondary outcomes included cost-effectiveness, clinical utility and implementation feasibility. Results Twenty-seven studies were included, of which 26 were published from 2020 onwards. Only one study was prospective, while the rest were retrospective. Commonly used ML algorithms for spine trauma prognosis were logistic regression (LR), extreme gradient boosting (XGBoost), Random Forest (RF), light gradient boosting machine (LightGBM), and support vector machine (SVM). Outcomes predicted include mortality, neurological function or recovery, ambulation and walking, self-care and independence, complications, treatment failure, length of stay, and discharge destination. Most studies employed internal testing and validation; only four reported external validation. Seven studies reported direct comparison with non-ML models or risk scores, demonstrating comparable or superior performance of ML models. Performance metrics include area under the curve (AUC), accuracy, sensitivity, specificity, precision, F1-score, Brier score, and others. The highest AUC was reported by a nomogram constructed using consensus clustering to predict postoperative pulmonary infection in patients with acute cervical spinal cord injury (internal validation; AUC 0.993; 95% CI 0.981–1.000). Quality of evidence varied between studies, but risk of bias was a concern. Conclusions Existing evidence on ML for spine trauma prognosis is characterized by retrospective study designs, homogeneous cohorts, and lack of external validation, limiting their generalizability and real-world application. While ML approaches demonstrate encouraging predictive performance for spine trauma outcomes, their clinical adoption is limited by methodological heterogeneity. More robust validation, standardized reporting, and comparison with traditional tools are needed before ML models can reliably inform clinical decision-making.

To enhance the performance of machine learning (ML) models for the post-embolization recanalization of cerebral aneurysms, we evaluated the impact of hemodynamic feature derivation and selection method on six ML algorithms. We utilized computational fluid dynamics (CFD) to simulate hemodynamics in 66 cerebral aneurysms from 65 patients, including 57 stable and nine recanalized aneurysms. We derived a total of 107 features for each aneurysm, encompassing four clinical features, 12 morphological features, and 91 hemodynamic features. To investigate the influence of feature derivation and selection methods on the ML models, we employed two derivation methods, simplified and fully derived, in combination with four selection methods: all features, statistically significant analysis, stepwise multivariate logistic regression analysis (stepwise-LR), and recursive feature elimination (RFE). Model performance was assessed using the area under the receiver operating characteristic curve (AUROC) and precision-recall curve (AUPRC) on both the training and testing datasets. The AUROC values on the testing dataset exhibited a wide-ranging spectrum, spanning from 0.373 to 0.863. Fully derived features and the RFE selection method demonstrated superior performance in intra-model comparisons. The multi-layer perceptron (MLP) model, trained with RFE-selected fully derived features, achieved the best performance on the testing dataset, with an AUROC value of 0.863 (95% CI: 0.684- 1.000). Our study demonstrated the importance of feature derivation and selection in determining the performance of ML models. This enabled the development of accurate decision-making models without the need to invade the patient.

Objective: To investigate the feasibility of a machine learning (ML) model based on radiomic features to identify active giant cell arteritis (GCA) in the aorta and differentiate it from atherosclerosis in follow-up [18F]FDG-PET/CT images for therapy monitoring. Methods: To train the ML model, 64 [18F]FDG-PET scans of 34 patients with proven GCA and 34 control subjects with type 2 diabetes mellitus were retrospectively included. The aorta was delineated into the ascending, arch, descending, and abdominal aorta. From each segment, 95 features were extracted. All segments were randomly split into a training/validation (n = 192; 80%) and test set (n = 46; 20%). In total, 441 ML models were trained, using combinations of seven feature selection methods, seven classifiers, and nine different numbers of features. The performance was assessed by area under the curve (AUC). The best performing ML model was compared to the clinical report of nuclear medicine physicians in 19 follow-up scans (7 active GCA, 12 inactive GCA). For explainability, an occlusion map was created to illustrate the important regions of the aorta for the decision of the ML model. Results: The ten-feature model with ANOVA as the feature selector and random forest classifier demonstrated the highest performance (AUC = 0.92 ± 0.01). Compared with the clinical report, this model showed a higher PPV (0.83 vs. 0.80), NPV (0.85 vs. 0.79), and accuracy (0.84 vs. 0.79) in the detection of active GCA in follow-up scans. Conclusions: The current radiomics ML model was able to identify active GCA and differentiate GCA from atherosclerosis in follow-up [18F]FDG-PET/CT scans. This demonstrates the potential of the ML model as a monitoring tool in challenging [18F]FDG-PET scans of GCA patients.

Racial and Ethnic Disparities in Predictive Accuracy of Machine Learning Algorithms Developed Using a National Database for 30-Day Complications Following Total Joint Arthroplasty

BackgroundCervical cancer is a common malignant tumor of the female reproductive system and is considered a leading cause of mortality in women worldwide. The analysis of time to event, which is crucial for any clinical research, can be well done with the method of survival prediction. This study aims to systematically investigate the use of machine learning to predict survival in patients with cervical cancer.MethodAn electronic search of the PubMed, Scopus, and Web of Science databases was performed on October 1, 2022. All articles extracted from the databases were collected in an Excel file and duplicate articles were removed. The articles were screened twice based on the title and the abstract and checked again with the inclusion and exclusion criteria. The main inclusion criterion was machine learning algorithms for predicting cervical cancer survival. The information extracted from the articles included authors, publication year, dataset details, survival type, evaluation criteria, machine learning models, and the algorithm execution method.ResultsA total of 13 articles were included in this study, most of which were published from 2018 onwards. The most common machine learning models were random forest (6 articles, 46%), logistic regression (4 articles, 30%), support vector machines (3 articles, 23%), ensemble and hybrid learning (3 articles, 23%), and Deep Learning (3 articles, 23%). The number of sample datasets in the study varied between 85 and 14946 patients, and the models were internally validated except for two articles. The area under the curve (AUC) range for overall survival (0.40 to 0.99), disease-free survival (0.56 to 0.88), and progression-free survival (0.67 to 0.81), respectively from (lowest to highest) received. Finally, 15 variables with an effective role in predicting cervical cancer survival were identified.ConclusionCombining heterogeneous multidimensional data with machine learning techniques can play a very influential role in predicting cervical cancer survival. Despite the benefits of machine learning, the problem of interpretability, explainability, and imbalanced datasets is still one of the biggest challenges. Providing machine learning algorithms for survival prediction as a standard requires further studies.

ObjectiveTo build a machine learning (ML) prediction model for prostate cancer (PCa) from transrectal ultrasound video clips of the whole prostate gland, diagnostic performance was compared with magnetic resonance imaging (MRI).MethodsWe systematically collated data from 501 patients—276 with prostate cancer and 225 with benign lesions. From a final selection of 231 patients (118 with prostate cancer and 113 with benign lesions), we randomly chose 170 for the purpose of training and validating a machine learning model, while using the remaining 61 to test a derived model. We extracted 851 features from ultrasound video clips. After dimensionality reduction with the least absolute shrinkage and selection operator (LASSO) regression, 14 features were finally selected and the support vector machine (SVM) and random forest (RF) algorithms were used to establish radiomics models based on those features. In addition, we creatively proposed a machine learning models aided diagnosis algorithm (MLAD) composed of SVM, RF, and radiologists’ diagnosis based on MRI to evaluate the performance of ML models in computer-aided diagnosis (CAD). We evaluated the area under the curve (AUC) as well as the sensitivity, specificity, and precision of the ML models and radiologists’ diagnosis based on MRI by employing receiver operator characteristic curve (ROC) analysis.ResultsThe AUC, sensitivity, specificity, and precision of the SVM in the diagnosis of PCa in the validation set and the test set were 0.78, 63%, 80%; 0.75, 65%, and 67%, respectively. Additionally, the SVM model was found to be superior to senior radiologists’ (SR, more than 10 years of experience) diagnosis based on MRI (AUC, 0.78 vs. 0.75 in the validation set and 0.75 vs. 0.72 in the test set), and the difference was statistically significant (p< 0.05).ConclusionThe prediction model constructed by the ML algorithm has good diagnostic efficiency for prostate cancer. The SVM model’s diagnostic efficiency is superior to that of MRI, as it has a more focused application value. Overall, these prediction models can aid radiologists in making better diagnoses.

Cervical cancer (CC) is one of the most common gynecological malignancies. Previous studies have shown that the prognosis of CC is affected by many factors. Our study aimed to identify key prognostic factors and use machine learning and deep learning algorithms to construct models to predict the overall survival (OS) of CC patients. Data of CC patients collected between 2007 and 2016 were collected from the Surveillance, Epidemiology, and End Results (SEER) database, and were randomly divided into the training set (1,743 patients) and test set (747 patients). Moreover, in order to enhance the practical application of the model, we conducted an X-tile analysis to categorize the patients into three distinct strata based on their age and tumor size. Least absolute shrinkage and selection operator (LASSO) and multivariate Cox regression were performed to identify the independent prognostic factors for OS, which were further used to construct CoxBoost, RandomForest, SuperPC XGBoost, and DeepSurv survival models to predict 1-, 3-, and 5-year OS. The parameters, including age, marital status, grade, tumor size, surgery, radiation, race, the American Joint Committee on Cancer (AJCC)_stage, AJCC_T, and AJCC_M, were associated with survival and were further incorporated into the five models. The concordance index (C-index) value was 0.858, 0.848, 0.849, 0.840, and 0.869, respectively, and the receiver operating characteristic (ROC) curves showed exceptional predictive performance. Among the five models, DeepSurv was the model with best performance. The ROC curve validated the area under the curve (AUC) values for 1-year OS, 3-year OS, and 5-year OS, which were 0.936, 0.915, and 0.900, respectively. The prognostic model conducted by DeepSurv algorithm and the independent prognostic factors can potentially be applied in making personalized treatment plans and evaluating the prognosis of CC patients.

Accurate estimation of reference evapotranspiration (ETo) plays a vital role in irrigation and water resource planning. The Penman–Monteith method recommended by the Food and Agriculture Organization (FAO PM56) is widely used and considered a standard to calculate ETo. However, FAO PM56 cannot be used with limited meteorological variables, so it is compulsory to choose an alternative model for ETo estimation, which requires fewer variables. This study built ten machine learning (ML) models based on multi-function, neural network, and tree-based structure against the FAO PM56 method. For this purpose, time series temperature data on a monthly scale are only used to train ML models. The developed ML models were applied to estimate ETo at different test stations and the obtained results were compared with the FAO PM56 method to verify and validate their performance in ETo estimation for the selected stations. In addition, multiple statistical indicators, including root-mean-square error (RMSE), coefficient of determination (R2), mean absolute error (MAE), Nash–Sutcliffe efficiency (NSE), and correlation coefficient (r) were calculated to compare the performance of each ML model on ETo estimation. Among the applied ML models, the ETo tree boost (TB) ML model outperformed the other ML models in estimating ETo in diverse climatic conditions based on statistical indicators (R2, NSE, r, RMSE, and MAE). Moreover, the observed R2, NSE, and r were the highest for the TB ML model, while RMSE and MAE were found to be the lowest at the study sites compared to other applied ML models. Lastly, ETo point data yielded from the TB ML model was used in an interpolation process to create monthly and annual ETo maps. Based on the ETo maps, this study suggests mainly a focus on areas with high ETo values and proper irrigation scheduling of crops to ensure water sustainability.