Pavement Roughness Prediction Using Explainable and Supervised Machine Learning Technique for Long-Term Performance

Abstract. As air pollution is regarded as the single largest environmental health risk in Europe it is important that communication to the public is up to date and accurate and provides means to avoid exposure to high air pollution levels. Long- and short-term exposure to outdoor air pollution is associated with increased risks of mortality and morbidity. Up-to-date information on present and coming days' air quality helps people avoid exposure during episodes with high levels of air pollution. Air quality forecasts can be based on deterministic dispersion modelling, but to be accurate this requires detailed information on future emissions, meteorological conditions and process-oriented dispersion modelling. In this paper, we apply different machine learning (ML) algorithms – random forest (RF), extreme gradient boosting (XGB), and long short-term memory (LSTM) – to improve 1, 2, and 3 d deterministic forecasts of PM10, NOx, and O3 at different sites in Greater Stockholm, Sweden. It is shown that the deterministic forecasts can be significantly improved using the ML models but that the degree of improvement of the deterministic forecasts depends more on pollutant and site than on what ML algorithm is applied. Also, four feature importance methods, namely the mean decrease in impurity (MDI) method, permutation method, gradient-based method, and Shapley additive explanations (SHAP) method, are utilized to identify significant features that are common and robust across all models and methods for a pollutant. Deterministic forecasts of PM10 are improved by the ML models through the input of lagged measurements and Julian day partly reflecting seasonal variations not properly parameterized in the deterministic forecasts. A systematic discrepancy by the deterministic forecasts in the diurnal cycle of NOx is removed by the ML models considering lagged measurements and calendar data like hour and weekday, reflecting the influence of local traffic emissions. For O3 at the urban background site, the local photochemistry is not properly accounted for by the relatively coarse Copernicus Atmosphere Monitoring Service ensemble model (CAMS) used here for forecasting O3 but is compensated for using the ML models by taking lagged measurements into account. Through multiple repetitions of the training process, the resulting ML models achieved improvements for all sites and pollutants. For NOx at street canyon sites, mean squared error (MSE) decreased by up to 60 %, and seven metrics, such as R2 and mean absolute percentage error (MAPE), exhibited consistent results. The prediction of PM10 is improved significantly at the urban background site, whereas the ML models at street sites have difficulty capturing more information. The prediction accuracy of O3 also modestly increased, with differences between metrics. Further work is needed to reduce deviations between model results and measurements for short periods with relatively high concentrations (peaks) at the street canyon sites. Such peaks can be due to a combination of non-typical emissions and unfavourable meteorological conditions, which are rather difficult to forecast. Furthermore, we show that general models trained using data from selected street sites can improve the deterministic forecasts of NOx at the station not involved in model training. For PM10 this was only possible using more complex LSTM models. An important aspect to consider when choosing ML algorithms is the computational requirements for training the models in the deployment of the system. Tree-based models (RF and XGB) require fewer computational resources and yield comparable performance in comparison to LSTM. Therefore, tree-based models are now implemented operationally in the forecasts of air pollution and health risks in Stockholm. Nevertheless, there is big potential to develop generic models using advanced ML to take into account not only local temporal variation but also spatial variation at different stations.

Propofol is a widely used sedative-hypnotic agent for critically-ill patients requiring invasive mechanical ventilation (IMV). Despite its clinical benefits, propofol is associated with increased risks of hypertriglyceridemia. Early identification of patients at risk for propofol-associated hypertriglyceridemia is crucial for optimizing sedation strategies and preventing adverse outcomes. Machine learning (ML) models offer a promising approach for predicting individualized patient risks of propofol-associated hypertriglyceridemia. We propose the development of a ML model aimed at predicting the risk of propofol-associated hypertriglyceridemia in ICU patients receiving IMV. The study will utilize retrospective data from four Mayo Clinic sites. Nested cross-validation (CV) will be employed, with a 10-fold inner CV loop for model tuning and selection as well as an outer loop using leave-one-site-out CV for external validation. Feature selection will be conducted using Boruta and LASSO-penalized logistic regression. Data preprocessing steps include missing data imputation, feature scaling, and dimensionality reduction techniques. Six ML algorithms will be tuned and evaluated. Bayesian optimization will be used for hyperparameter selection. Global model explainability will be assessed using permutation importance, and local model explainability will be assessed using SHapley Additive exPlanations (SHAP). The proposed ML model aims to provide a reliable and interpretable tool for clinicians to predict the risk of propofol-associated hypertriglyceridemia in ICU patients. The final model will be deployed in a web-based clinical risk calculator. The model development process and performance measures obtained during nested cross-validation will be described in a study publication to be disseminated in a peer-reviewed journal. The proposed study has received ethics approval from the Mayo Clinic Institutional Review Board (IRB #23-007416). Robust external validation using a nested cross-validation (CV) framework will help assess the generalizability of models produced from the modeling pipeline across different hospital settings.A diverse set of machine learning (ML) algorithms and advanced hyperparameter tuning techniques will be employed to identify the most optimal model configuration.Integration of feature explainability will enhance the clinical applicability of the ML models by providing transparency in predictions, which can improve clinician trust and encourage adoption.Reliance on retrospective data may introduce biases due to inconsistent or erroneous data collection, and the computational intensity of the validation approach may limit replication and future model expansion in resource-constrained settings.

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.

Background Patients with atrial fibrillation (AF) after successful transcatheter aortic valve implantation (TAVI) are at heightened risk of ischaemic stroke (IS) and bleeding. However, risk scores, such as CHA2DS2-VA and HAS-BLED, provide modest prediction of IS and bleeding. Although traditional statistical methods (e.g., Cox regression) allow for identifying patients at higher risk for these events, a machine learning (ML) approach may enhance risk prediction by capturing complex non-linear associations. Purpose To develop and evaluate ML models predicting clinical events in patients with AF after TAVI with established risk scores for IS and bleeding. Methods Patient-level data from the ENVISAGE-TAVI AF trial were used to develop ML models for the prediction of IS, major gastrointestinal bleeding (MGIB), all clinically relevant bleeding (major or clinically relevant nonmajor bleeding), and net adverse clinical events (NACE; composite of death from any cause, myocardial infarction, IS, systemic thromboembolic event, valve thrombosis, or major bleeding). For each outcome, 10 ML algorithms were trained, optimised, and ranked by performance using nested cross-validation. The model with the highest F1 score (harmonic mean of precision and recall) for each outcome was selected and validated on a separate hold-out set (25%). SHAP (SHapley Additive exPlanations) values were calculated to determine the average magnitude of feature contributions. Using F1 scores, the best model of each outcome was compared with logistic regression models trained exclusively on CHA2DS2-VA (IS) and HAS-BLED (bleeding) scores. Results Of 1377 patients on treatment, 41 had IS, 83 had MGIB, 375 had clinically relevant bleeding, and 255 had NACE. The predictive abilities of a linear discriminant analysis algorithm for IS (F1 score=0.08) and CHA2DS2-VA (F1 score=0.09) were similarly low and numerically better than HAS-BLED (F1 score=0.05; Figure 1). Prediction of MGIB was similarly low for a logistic-lasso algorithm (F1 score=0.11), CHA2DS2-VA (F1 score=0.09), and HAS-BLED (F1 score=0.12). For all clinically relevant bleeding, the predictive performance of a naïve-Bayes algorithm (F1 score=0.39) was similar to that of CHA2DS2-VA (F1 score=0.38) and HAS-BLED (F1 score=0.41). The predictive ability of a logistic regression algorithm for NACE (F1 score=0.33) was numerically better than CHA2DS2-VA (F1 score=0.22) or HAS-BLED (F1 score=0.27). Low event rates were generally observed to limit the predictive power of ML models and scores. All 4 algorithms identified novel predictors of events (Figure 2). Conclusion ML models allow for risk assessment for IS, MGIB, all clinically relevant bleeding, and NACE, and were comparable to traditional risk scores. While further development and validation in larger datasets will be required, these initial models reveal potential new predictors of IS and bleeding events that may be important to consider in future studies.

Air pollution in Macau has become a serious problem following the Pearl River Delta’s (PRD) rapid industrialization that began in the 1990s. With this in mind, Macau needs an air quality forecast system that accurately predicts pollutant concentration during the occurrence of pollution episodes to warn the public ahead of time. Five different state-of-the-art machine learning (ML) algorithms were applied to create predictive models to forecast PM2.5, PM10, and CO concentrations for the next 24 and 48 h, which included artificial neural networks (ANN), random forest (RF), extreme gradient boosting (XGBoost), support vector machine (SVM), and multiple linear regression (MLR), to determine the best ML algorithms for the respective pollutants and time scale. The diurnal measurements of air quality data in Macau from 2016 to 2021 were obtained for this work. The 2020 and 2021 datasets were used for model testing, while the four-year data before 2020 and 2021 were used to build and train the ML models. Results show that the ANN, RF, XGBoost, SVM, and MLR models were able to provide good performance in building up a 24-h forecast with a higher coefficient of determination (R2) and lower root mean square error (RMSE), mean absolute error (MAE), and biases (BIAS). Meanwhile, all the ML models in the 48-h forecasting performance were satisfactory enough to be accepted as a two-day continuous forecast even if the R2 value was lower than the 24-h forecast. The 48-h forecasting model could be further improved by proper feature selection based on the 24-h dataset, using the Shapley Additive Explanations (SHAP) value test and the adjusted R2 value of the 48-h forecasting model. In conclusion, the above five ML algorithms were able to successfully forecast the 24 and 48 h of pollutant concentration in Macau, with the RF and SVM models performing the best in the prediction of PM2.5 and PM10, and CO in both 24 and 48-h forecasts.

The accurate detection and assessment of stress play a pivotal role in enhancing individual well-being and healthcare outcomes. Traditional methods of stress detection often grapple with limitations in accuracy and scalability. With the advent of machine learning (ML), the potential to revolutionize stress detection has emerged. This paper presents a comprehensive study on the application of ML algorithms for stress detection, with a focus on physiological and behavioral data analysis. Central to our approach is the integration of SHapley Additive exPlanations (SHAP), an Explainable Artificial Intelligence (XAI) technique, to interpret ML models. SHAP provides a novel lens to understand the impact of individual features in the complex decision-making processes of ML models, thereby enhancing the transparency and reliability of stress predictions. We demonstrate how SHAP not only aids in elucidating model decisions but also contributes to refining the models for greater accuracy. Our results highlight the effectiveness of ML in detecting stress and the pivotal role of XAI in making these models more interpretable and trustworthy. This study underscores the synergy between advanced ML techniques and XAI, paving the way for more nuanced and reliable stress detection methodologies that are essential in diverse settings, from healthcare to workplace environments.

Explainable Artificial Intelligence (XAI) is the capability of explaining the reasoning behind the choices made by the machine learning (ML) algorithm which can help understand and maintain the transparency of the decision-making capability of the ML algorithm. Humans make thousands of decisions every day in their lives. Every decision an individual makes, they can explain the reasons behind why they made the choices that they made. Nonetheless, it is not the same in the case of ML and AI systems. Furthermore, XAI was not wideley researched until suddenly the topic was brought forward and has been one of the most relevant topics in AI for trustworthy and transparent outcomes. XAI tries to provide maximum transparency to a ML algorithm by answering questions about how models effectively came up with the output. ML models with XAI will have the ability to explain the rationale behind the results, understand the weaknesses and strengths the learning models, and be able to see how the models will behave in the future. In this paper, we investigate XAI for algorithmic trustworthiness and transparency. We evaluate XAI using some example use cases and by using SHAP (SHapley Additive exPlanations) library and visualizing the effect of features individually and cumulatively in the prediction process.

Chronic pancreatitis results in pancreatic exocrine insufficiency (PEI), which is treated with pancreatic enzyme replacement therapy (PERT). Despite the clinical benefits, non-compliance to PERT is a frequent problem. Our study aimed at (a) identifying predictors of non-compliance to PERT using machine learning (ML) algorithms and (b) analyzing patient-reported reasons for non-compliance to PERT. A prospective observational study was conducted at a high-volume tertiary care center on two independent cohorts of chronic pancreatitis patients on PERT. In Cohort 1 (1057 patients screened), we used ML algorithms to identify predictors of non-compliance to PERT. The best ML model based on performance metrics was chosen for Shapley Additive explanations (SHAP) analysis. In Cohort 2 (465 patients screened), we conducted detailed interviews to understand patient-reported reasons for non-compliance. In Cohort 1 (751 patients analyzed; median age, 37.5 years; males, 73.1%; idiopathic, 61.9%), 166 (22.1%) patients were non-compliant to PERT. Extreme gradient boosting (XGBoost) exhibited the highest accuracy (area under the curve, AUC = 0.91). The strongest predictors of non-compliance based on SHAP were disease duration, age, fat-restricted diet, rural residence and educational status. A non-compliance (NC) score was developed based on SHAP. In Cohort 2 (129 patients analyzed; mean age, 36 years; males, 72.1%; idiopathic, 52.3%), high treatment costs (34.1%), negligence (19.4%) and adverse effects (10.9%) were the most reported reasons for non-compliance. This study identifies predictors of non-compliance to PERT (disease duration, age, fat-restricted diet, rural habitat, undergraduate education status) in patients with chronic pancreatitis using machine-learning algorithms. The NC score can be a useful tool to identify patients at risk for non-compliance, who can be subjected to targeted counselling. The NC score needs to be validated in large, independent, multi-centre cohorts of patients.

Extracorporeal membrane oxygenation-induced coagulopathy (ECMO-IC) represents a frequent and severe complication, contributing to oxygenator replacement and unfavorable outcomes. Currently, no reliable machine learning (ML) model exists for early identification. This study comprehensively assesses routine clinical characteristics to develop a reliable, accurate, and explainable ML model for estimating ECMO-IC risk and to identify modifiable factors. This study included two center cohorts with 266 patients undergoing ECMO from 2015 to 2024. Feature selection utilized the Boruta algorithm, followed by the implementation of a distinctive ML framework incorporating 12 ML algorithms to establish a consensus prediction model (ECMO-IC index). Model and feature variable assessment employed multiple analytical methods: Bootstrapping and fivefold cross-validation, subgroup and interaction analysis, restricted cubic spline (RCS) regression, and threshold effect analysis. Model interpretation and feature quantification relied on the Shapley Additive Explanations (SHAP) methodology for visualization purposes. Through Boruta algorithm selection, 17 characteristics were identified and incorporated into 12 ML methodologies, generating 105 permutations and an optimal algorithm for identifying ECMO-IC. The ECMO-IC index comprising 9 modifiable or nonmodifiable variables, namely platelet (PLT), lactate, systemic immune-inflammation index (SII), K, total protein (TP), shock index (SI), red blood cell volume distribution width (RDWCV), acute physiology and chronic health evaluation II (APACHE II), and Ca, demonstrated strong diagnostic capabilities, achieving a mean area under the curve (AUC) of 0.815 across derivation (AUC = 0.817) and validation (AUC = 0.813) cohorts, along with notable discriminatory power, model fit, and clinical utility. SHAP elucidates the importance of ranking features (PLT, lactate, K, Ca and APACHE II) and visualises global and individual ECMO-IC risk prediction. RCS regression and threshold effect analysis suggested a nonlinear link between model features (PLT: P for nonlinearity = 0.002, SII: P for nonlinearity = 0.001, K: P for nonlinearity = 0.006, Ca: P for nonlinearity = 0.008, and lactate: P for nonlinearity = 0.004) and ECMO-IC, and generated an inflection point for features (PLT = 95 × 109/L, lactate = 5.7mmol/L, SII = 200, K = 4.4mmol/L, TP = 45.6g/L, SI = 0.8, RDWCV = 14%, APACHE II = 15, Ca = 1.03mmol/L). To provide a more flexible predictive tool, the ECMO-IC model was constructed using a free, publicly available web-based calculator ( https://genglongliu.shinyapps.io/DynNomapp/ ). An optimised explainable ML model (ECMO-IC index) incorporating several modifiable parameters was established and internally validated to deliver an readily available and accurate diagnostic tool for ECMO-IC, with potential applications in ECMO clinical management.

This study focuses on using various machine learning (ML) models to evaluate the shear behaviors of ultra-high-performance concrete (UHPC) beams reinforced with glass fiber-reinforced polymer (GFRP) bars. The main objective of the study is to predict the shear strength of UHPC beams reinforced with GFRP bars using ML models. We use four different ML models: support vector machine (SVM), artificial neural network (ANN), random forest (R.F.), and extreme gradient boosting (XGBoost). The experimental database used in the study is acquired from various literature sources and comprises 54 test observations with 11 input features. These input features are likely parameters related to the composition, geometry, and properties of the UHPC beams and GFRP bars. To ensure the ML models' generalizability and scalability, random search methods are utilized to tune the hyperparameters of the algorithms. This tuning process helps improve the performance of the models when predicting the shear strength. The study uses the ACI318M-14 and Eurocode 2 standard building codes to predict the shear capacity behavior of GFRP bars-reinforced UHPC I-shaped beams. The ML models' predictions are compared to the results obtained from these building code standards. According to the findings, the XGBoost model demonstrates the highest predictive test performance among the investigated ML models. The study employs the SHAP (SHapley Additive exPlanations) analysis to assess the significance of each input parameter in the ML models' predictive capabilities. A Taylor diagram is used to statistically compare the accuracy of the ML models. This study concludes that ML models, particularly XGBoost, can effectively predict the shear capacity behavior of GFRP bars-reinforced UHPC I-shaped beams.

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.

BACKGROUND Acute kidney injury (AKI) is a common adverse outcome following nephrectomy. The progression from AKI to acute kidney disease (AKD) and subsequently to chronic kidney disease (CKD) remains a concern; yet, the predictive mechanisms for these transitions are not fully understood. Interpretable machine learning (ML) models offer insights into how clinical features influence long-term renal function outcomes after nephrectomy, providing a more precise framework for identifying patients at risk and supporting improved clinical decision-making processes. OBJECTIVE This study aimed to (1) evaluate postnephrectomy rates of AKI, AKD, and CKD, analyzing long-term renal outcomes along different trajectories; (2) interpret AKD and CKD models using Shapley Additive Explanations values and Local Interpretable Model-Agnostic Explanations algorithm; and (3) develop a web-based tool for estimating AKD or CKD risk after nephrectomy. METHODS We conducted a retrospective cohort study involving patients who underwent nephrectomy between July 2012 and June 2019. Patient data were randomly split into training, validation, and test sets, maintaining a ratio of 76.5:8.5:15. Eight ML algorithms were used to construct predictive models for postoperative AKD and CKD. The performance of the best-performing models was assessed using various metrics. We used various Shapley Additive Explanations plots and Local Interpretable Model-Agnostic Explanations bar plots to interpret the model and generated directed acyclic graphs to explore the potential causal relationships between features. Additionally, we developed a web-based prediction tool using the top 10 features for AKD prediction and the top 5 features for CKD prediction. RESULTS The study cohort comprised 1559 patients. Incidence rates for AKI, AKD, and CKD were 21.7% (n=330), 15.3% (n=238), and 10.6% (n=165), respectively. Among the evaluated ML models, the Light Gradient-Boosting Machine (LightGBM) model demonstrated superior performance, with an area under the receiver operating characteristic curve of 0.97 for AKD prediction and 0.96 for CKD prediction. Performance metrics and plots highlighted the model’s competence in discrimination, calibration, and clinical applicability. Operative duration, hemoglobin, blood loss, urine protein, and hematocrit were identified as the top 5 features associated with predicted AKD. Baseline estimated glomerular filtration rate, pathology, trajectories of renal function, age, and total bilirubin were the top 5 features associated with predicted CKD. Additionally, we developed a web application using the LightGBM model to estimate AKD and CKD risks. CONCLUSIONS An interpretable ML model effectively elucidated its decision-making process in identifying patients at risk of AKD and CKD following nephrectomy by enumerating critical features. The web-based calculator, found on the LightGBM model, can assist in formulating more personalized and evidence-based clinical strategies.

BackgroundNeoadjuvant immunotherapy has been shown to improve survival in patients with gastric cancer. This study sought to develop and validate a radiomics-based machine learning (ML) model for patients with locally advanced gastric cancer (LAGC), specifically to predict whether patients will achieve a major pathological response (MPR) following neoadjuvant immunotherapy. With its predictive capabilities, this tool shows promise for enhancing clinical decision-making processes in the future.MethodsThis study utilized a multicenter cohort design, retrospectively gathering clinical data and computed tomography (CT) images from 268 patients diagnosed with advanced gastric cancer who underwent neoadjuvant immunotherapy between January 2019 and December 2023 from two medical centers. Radiomic features were extracted from CT images, and a multi-step feature selection procedure was applied to identify the top 20 representative features. Nine ML algorithms were implemented to build prediction models, with the optimal algorithm selected for the final prediction model. The hyperparameters of the chosen model were fine-tuned using Bayesian optimization and grid search. The performance of the model was evaluated using several metrics, including the area under the curve (AUC), accuracy, and Cohen’s kappa coefficient.ResultsThree cohorts were included in this study: the development cohort (DC, n = 86), the internal validation cohort (IVC, n = 59), and the external validation cohort (EVC, n = 52). Nine ML models were developed using DC cases. Among these, an optimized Bayesian-LightGBM model, demonstrated robust predictive performance for MPR following neoadjuvant immunotherapy in LAGC patients across all cohorts. Specifically, within DC, the LightGBM model attained an AUC of 0.828, an overall accuracy of 0.791, a Cohen’s kappa coefficient of 0.552, a sensitivity of 0.742, a specificity of 0.818, a positive predictive value (PPV) of 0.586, a negative predictive value (NPV) of 0.867, a Matthews correlation coefficient (MCC) of 0.473, and a balanced accuracy of 0.780. Comparable performance metrics were validated in both the IVC and the EVC, with AUC values of 0.777 and 0.714, and overall accuracies of 0.729 and 0.654, respectively. These results suggested good fitness and generalization of the Bayesian-LightGBM model. Shapley Additive Explanations (SHAP) analysis identified significant radiomic features contributing to the model’s predictive capability. The SHAP values of the features wavelet.LLH_gldm_SmallDependenceLowGrayLevelEmphasis, wavelet.HHL_glrlm_RunVariance, and wavelet.LLH_glszm_LargeAreaHighGrayLevelEmphasis were ranked among the top three, highlighting their significant contribution to the model’s predictive performance. In contrast to existing radiomic models that exclusively focus on neoadjuvant chemotherapy, our model integrates both neoadjuvant immunotherapy and chemotherapy, thereby offering more precise predictive capabilities.ConclusionThe radiomics-based ML model demonstrated significant efficacy in predicting the pathological response to neoadjuvant immunotherapy in LAGC patients, thereby providing a foundation for personalized treatment strategies.

Machine learning for classifying chronic ankle instability based on ankle strength, range of motion, postural control and anatomical deformities in delivery service workers with a history of lateral ankle sprains.

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.