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Machine learning classifiers do not improve prediction of hospitalization > 2 days after fast-track hip and knee arthroplasty compared with a classical statistical risk model
BACKGROUND AND PURPOSE: Prediction of postoperative outcomes and length of hospital stay (LOS) of patients is vital for allocation of healthcare resources. We investigated the performance of prediction models based on machinelearning algorithms compared with a previous risk stratification model usin...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8815306/ https://www.ncbi.nlm.nih.gov/pubmed/34984485 http://dx.doi.org/10.2340/17453674.2021.843 |
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author | JOHANNESDOTTIR, Katrin B KEHLET, Henrik PETERSEN, Pelle B AASVANG, Eske K SØRENSEN, Helge B D JØRGENSEN, Christoffer C |
author_facet | JOHANNESDOTTIR, Katrin B KEHLET, Henrik PETERSEN, Pelle B AASVANG, Eske K SØRENSEN, Helge B D JØRGENSEN, Christoffer C |
author_sort | JOHANNESDOTTIR, Katrin B |
collection | PubMed |
description | BACKGROUND AND PURPOSE: Prediction of postoperative outcomes and length of hospital stay (LOS) of patients is vital for allocation of healthcare resources. We investigated the performance of prediction models based on machinelearning algorithms compared with a previous risk stratification model using traditional multiple logistic regression, for predicting the risk of a LOS of > 2 days after fast-track total hip and knee replacement. PATIENTS AND METHODS: 3 different machine learning classifiers were trained on data from the Lundbeck Centre for Fast-track Hip and Knee Replacement Database (LCDB) collected from 9,512 patients between 2016 and 2017. The chosen classifiers were a random forest classifier (RF), a support vector machine classifier with a polynomial kernel (SVM), and a multinomial Naïve-Bayes classifier (NB). RESULTS: Comparing performance measures of the classifiers with the traditional model revealed that all the models had a similar performance in terms of F1 score, accuracy, sensitivity, specificity, area under the receiver operating curve (AUC), and area under the precision-recall curve (AUPRC). A feature importance analysis of the RF classifier found hospital, age, use of walking aid, living alone, and joint operated on to be the most relevant input features. None of the classifiers reached a clinically relevant performance with the input data from the LCDB. INTERPRETATION: Despite the promising prospects of machine-learning practices for disease and risk prediction, none of the machine learning models tested outperformed the traditional multiple regression model in predicting which patients in this cohort had a LOS > 2 days. |
format | Online Article Text |
id | pubmed-8815306 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation |
record_format | MEDLINE/PubMed |
spelling | pubmed-88153062022-02-16 Machine learning classifiers do not improve prediction of hospitalization > 2 days after fast-track hip and knee arthroplasty compared with a classical statistical risk model JOHANNESDOTTIR, Katrin B KEHLET, Henrik PETERSEN, Pelle B AASVANG, Eske K SØRENSEN, Helge B D JØRGENSEN, Christoffer C Acta Orthop Article BACKGROUND AND PURPOSE: Prediction of postoperative outcomes and length of hospital stay (LOS) of patients is vital for allocation of healthcare resources. We investigated the performance of prediction models based on machinelearning algorithms compared with a previous risk stratification model using traditional multiple logistic regression, for predicting the risk of a LOS of > 2 days after fast-track total hip and knee replacement. PATIENTS AND METHODS: 3 different machine learning classifiers were trained on data from the Lundbeck Centre for Fast-track Hip and Knee Replacement Database (LCDB) collected from 9,512 patients between 2016 and 2017. The chosen classifiers were a random forest classifier (RF), a support vector machine classifier with a polynomial kernel (SVM), and a multinomial Naïve-Bayes classifier (NB). RESULTS: Comparing performance measures of the classifiers with the traditional model revealed that all the models had a similar performance in terms of F1 score, accuracy, sensitivity, specificity, area under the receiver operating curve (AUC), and area under the precision-recall curve (AUPRC). A feature importance analysis of the RF classifier found hospital, age, use of walking aid, living alone, and joint operated on to be the most relevant input features. None of the classifiers reached a clinically relevant performance with the input data from the LCDB. INTERPRETATION: Despite the promising prospects of machine-learning practices for disease and risk prediction, none of the machine learning models tested outperformed the traditional multiple regression model in predicting which patients in this cohort had a LOS > 2 days. Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation 2022-01-03 /pmc/articles/PMC8815306/ /pubmed/34984485 http://dx.doi.org/10.2340/17453674.2021.843 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work. |
spellingShingle | Article JOHANNESDOTTIR, Katrin B KEHLET, Henrik PETERSEN, Pelle B AASVANG, Eske K SØRENSEN, Helge B D JØRGENSEN, Christoffer C Machine learning classifiers do not improve prediction of hospitalization > 2 days after fast-track hip and knee arthroplasty compared with a classical statistical risk model |
title | Machine learning classifiers do not improve prediction of hospitalization > 2 days after fast-track hip and knee arthroplasty compared with a classical statistical risk model |
title_full | Machine learning classifiers do not improve prediction of hospitalization > 2 days after fast-track hip and knee arthroplasty compared with a classical statistical risk model |
title_fullStr | Machine learning classifiers do not improve prediction of hospitalization > 2 days after fast-track hip and knee arthroplasty compared with a classical statistical risk model |
title_full_unstemmed | Machine learning classifiers do not improve prediction of hospitalization > 2 days after fast-track hip and knee arthroplasty compared with a classical statistical risk model |
title_short | Machine learning classifiers do not improve prediction of hospitalization > 2 days after fast-track hip and knee arthroplasty compared with a classical statistical risk model |
title_sort | machine learning classifiers do not improve prediction of hospitalization > 2 days after fast-track hip and knee arthroplasty compared with a classical statistical risk model |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8815306/ https://www.ncbi.nlm.nih.gov/pubmed/34984485 http://dx.doi.org/10.2340/17453674.2021.843 |
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