Predicting pathologic complete response in locally advanced rectal cancer patients after neoadjuvant therapy: a machine learning model using XGBoost

ObjectivesThis study is the first to develop and evaluate a machine learning (ML) model for predicting pelvic adhesions based on ultrasound features, utilizing the SHapley Additive Explanations (SHAP) framework for interpretability analysis.MethodsThis prospective study included 220 patients who underwent laparoscopic surgery and preoperative ultrasound assessments at our hospital between April 2023 and June 2024. Patients were randomly assigned to training and validation sets. A Least Absolute Shrinkage and Selection Operator regression was used to identify independent risk factors, followed by incorporation into an Extreme Gradient Boosting prediction model. Model performance was evaluated using receiver operating characteristic (ROC) curves, calibration plots, and a decision curve analysis.ResultsThe included patients were randomly divided into a training set and a validation set in a 7:3 ratio. The final model included four predictors—obstructed ovarian activity, surgical history, endometriosis, and gynecological inflammation—and demonstrated strong discriminatory performance, with an area under the ROC curve of 0.869 and 0.846 in the training and validation sets, respectively. The ML model demonstrated a sensitivity of 0.946 and a specificity of 0.597 in the training set, while in the validation set, it achieved a sensitivity of 1.000 and a specificity of 0.600. Calibration analyses showed good agreement between predicted and observed outcomes. The model exhibited high clinical utility. SHAP analysis revealed that endometriosis contributed most significantly to the predictions, followed by surgical history, obstructed ovarian activity, and gynecological inflammation.ConclusionsThe interpretable ML model developed in this study demonstrates strong predictive performance for assessing the risk of pelvic adhesions in patients prior to surgery. It can be utilized to accurately identify high-risk patients before the procedure, enabling the implementation of appropriate measures during surgery to reduce the occurrence of postoperative pelvic adhesions.

Improving autocoding performance of rare categories in injury classification: Is more training data or filtering the solution?

Data reformation – A novel data processing technique enhancing machine learning applicability for predicting streamflow extremes

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.

BackgroundIn patients with suspected obstructive coronary artery disease (CAD), evaluation using a pre-test probability model is the key element for diagnosis; however, its accuracy is controversial. This study aimed to develop machine learning (ML) models using clinically relevant biomarkers to predict the presence of stable obstructive CAD and to compare ML models with an established pre-test probability of CAD models.MethodsEight machine learning models for prediction of obstructive CAD were trained on a cohort of 1,312 patients [randomly split into the training (80%) and internal validation sets (20%)]. Twelve clinical and blood biomarker features assessed on admission were used to inform the models. We compared the best-performing ML model and established the pre-test probability of CAD (updated Diamond-Forrester and CAD consortium) models.ResultsThe CatBoost algorithm model showed the best performance (area under the receiver operating characteristics, AUROC, 0.796, and 95% confidence interval, CI, 0.740–0.853; Matthews correlation coefficient, MCC, 0.448) compared to the seven other algorithms. The CatBoost algorithm model improved risk prediction compared with the CAD consortium clinical model (AUROC 0.727; 95% CI 0.664–0.789; MCC 0.313). The accuracy of the ML model was 74.6%. Age, sex, hypertension, high-sensitivity cardiac troponin T, hemoglobin A1c, triglyceride, and high-density lipoprotein cholesterol levels contributed most to obstructive CAD prediction.ConclusionThe ML models using clinically relevant biomarkers provided high accuracy for stable obstructive CAD prediction. In real-world practice, employing such an approach could improve discrimination of patients with suspected obstructive CAD and help select appropriate non-invasive testing for ischemia.

Background: Despite the development of disease-modifying therapy (DMT) for patients with transthyretin amyloid cardiomyopathy (ATTR-CM), the rates of mortality and disease progression are still high. The conventional models to predict prognosis (e.g., the Columbia score, the National Amyloidosis Centre [NAC] staging) predate DMT and offer limited prediction in the era of DMT. Aim: To develop a novel prognostication model in patients with ATTR-CM using plasma proteomics. Hypothesis: Plasma proteomics improves the prediction of death and disease progression in patients with ATTR-CM beyond the conventional models. Methods: In this prospective study, we conducted plasma proteomics profiling of 7,289 proteins in patients with ATTR-CM (n=303) at enrollment. The primary outcome was all-cause death, and the secondary was disease progression–a composite of death, heart transplant, heart failure hospitalization, and oral diuretics intensification. We randomly divided the cohort into training (2/3) and test sets (1/3). In the training set, we specified proteins to predict both outcomes using the Boruta algorithm. Using the specified proteins, we developed a random forest-based machine-learning (ML) model to predict each outcome in the training set. We compared the predictive ability of the ML model with the conventional models in the test set. We performed survival analyses between high- and low-risk groups defined by the ML models in the test set, while adjusting for the Columbia score. Results: During a median follow-up of 3.9 [1 st –3 rd quartile: 2.2–5.9] years, 69 patients (23%) died and 124 (41%) had disease progression, despite 243 (80%) receiving DMT. In the training set, 17 proteins were specified to predict both outcomes. In the test set, the area under the receiver-operating-characteristic curve (AUC) of the ML model was 0.90 (95% confidence interval 0.84–0.96) for all-cause death and 0.82 (0.73–0.91) for disease progression ( Image 1 ). Each ML model outperformed the conventional models in AUC, classification, and time-dependent AUC ( Images 1, 2 ). The high-risk group in the test set specified by the ML model had a higher event rate than the low-risk group in each outcome (all-cause death, adjusted hazard ratio [aHR] 6.6 [2.5–18.0], P =0.0002; disease progression, aHR 5.7 [2.6–12.4], P <0.0001; Image 3 ). Conclusion: This study first demonstrated that plasma proteomics improves the prediction of mortality and disease progression in patients with ATTR-CM in the DMT era.

Lung adenocarcinoma (LUAD) is the leading cause of cancer-related deaths. High-resolution computed tomography (HRCT) has improved the detection of ground glass nodules (GGNs), which are early indicators of lung cancer. Accurate assessment of GGN invasiveness is crucial for determining the appropriate surgical approach. Dual-layer spectral detector computed tomography (DLCT) offers advanced imaging capabilities, including electron density and iodine density, which enhance the evaluation of GGN invasiveness. This study aims to develop a machine learning (ML) model that integrates DLCT parameters and clinical features to predict the invasiveness of GGNs in LUAD, aiding in surgical decision-making and prognosis improvement. The retrospective study encompassed 272 patients who were diagnosed with LUAD, comprising154 cases of invasive adenocarcinomas(IA) and118 cases of pre-invasive minimally invasive adenocarcinoma (MIA) which were then randomly allocated into atraining setand atest set. Six ML models were developed based on five DLCT parameters (conventional, iodine density, virtual noncontrast, electron density, and effective atomic number). Subsequently, a nomogram was constructed using multi-factor logistic regression, incorporating radiomic characteristics and clinicopathological risk factors. The ML model based on conventional plus electron density performed better than the models with other DLCT parameters,with the area under the curves (AUCs) of0.945 and 0.964 in the training and test sets, respectively. The clinical model and radiomics score (Rad-score) were combinedin the logistic regression to construct a joint model,of which the AUCs were0.974 in the training sets and 0.949 in the test sets. The ML model effectively differentiated between IA and pre-invasive MIA, and further classified patients into high and medium risk categories for invasion using waterfall plots. The ML model based on DLCT parameters helpspredict the invasiveness of GGNs and classifiesthe GGNs intodifferent risk grades.

Introduction: Early and accurate diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM) is known to improve prognosis. However, it is sometimes challenging to distinguish ATTR-CM from other cardiac conditions that cause left ventricular hypertrophy (LVH), such as hypertrophic cardiomyopathy (HCM), hypertensive LVH (h-LVH), and aortic stenosis (AS). The Mayo ATTR-CM score is commonly used to distinguish ATTR-CM from these mimickers. Herein, we constructed a machine learning (ML) model and compared its performance to the Mayo score. Hypothesis: A ML model based on readily available clinical variables will outperform the Mayo score in distinguishing ATTR-CM from other cardiac conditions that cause LVH. Methods: We performed a multicenter case-control study of 1,605 patients, including 303 ATTR-CM cases and 1,302 controls – i.e., 935 with HCM, 331 with h-LVH, and 36 with AS. We allocated the former two-thirds of each disease group to the training set and the latter one-third to the prospective test set for validation. We developed a main ML model in the training set using XGBoost with 18 clinical variables including demographics, comorbidities, laboratory values, and echocardiographic data. We examined its performance in the test set using the area under the receiver-operating-characteristic curve (AUC) and decision curve analysis (DCA). In addition, we developed a simplified ML model using only the top 5 variables identified by feature importance and tested its performance. Results: The top 5 most important variables were age, LV diameter in systole, LV posterior wall thickness in diastole, LV ejection fraction, and left atrial diameter ( Figure 1 ). The main ML model (AUC: 0.96, 95% CI: 0.93–0.98) outperformed the Mayo score (AUC: 0.84, 95% CI: 0.79–0.89, DeLong’s P <0.0001; Figure 2 ) in the test set. DCA demonstrated that the ML model provided greater net benefit across all threshold probabilities ( Figure 3 ). The simplified 5-variable model also outperformed the Mayo score (AUC: 0.94, 95% CI: 0.91–0.97, DeLong’s P <0.0001). Conclusions: In this multicenter study, we developed ML models that effectively distinguish ATTR-CM from its mimickers that cause LVH using readily available clinical variables. Given the simplicity and accuracy of our models, the present study serves as an important initial step toward the development of a robust, data-driven tool that could be readily automated and integrated into electronic medical record system to screen for ATTR-CM.

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.

Systematic literature review of machine learning based software development effort estimation models

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.

Aim: The majority of machine learning (ML) models in healthcare are built on retrospective data, much of which is collected without explicit patient consent for use in artificial intelligence (AI) and ML applications. The primary aim of this study was to evaluate whether clinicians and scientific researchers themselves consent to provide their own data for the training of ML models. Materials and Methods: This survey was conducted through an anonymous online survey, utilizing platforms such as Telegram, LinkedIn, and Viber. The target audience comprised specific international groups, primarily Russian, German, and English-speaking, of clinicians and scientific researchers. These participants ranged in their levels of expertise and experience, from beginners to veterans. The survey centered on a singular, pivotal question: “Do You Consent to the Use of Your Biological and Private Data for Training Machine Learning and AI Models?” Respondents had the option to choose from three responses: “Yes” and “No”. Results: The survey was conducted in January 2024. A total of 119 unique and verified individuals participated in the survey. The results revealed that only 50% of respondents (63 persons) expressed consent to provide their own data for the training of ML and AI models. Conclusion: In the development of ML and AI models, particularly open-source ones, it is crucial to ascertain whether participants are willing to provide their private data. While ML algorithms can transform the nature of data, it is important to remember that the primary owner of this data is the individual. Our findings show that in 50% of the cases, even participants from scientific research and clinical backgrounds – individuals typically accountable for ensuring data quality in AI and ML model development – do not consent to the use of their data in AI and ML settings. This highlights the need for more stringent consent processes and ethical considerations in the utilization of personal data in AI and ML research.

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-based water quality prediction using octennial in-situ Daphnia magna biological early warning system data

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