Development and Validation of Novel Deep-Learning Models Using Multiple Data Types for Lung Cancer Survival

SIMPLE SUMMARY: Previous survival-prediction studies have had several limitations, such as a lack of comprehensive clinical data types, testing only in limited machine-learning algorithms, or a lack of a sufficient external testing set. This lung-cancer-survival-prediction model is based on multiple data types, multiple novel machine-learning algorithms, and external testing. This predicted model demonstrated a higher performance (ANN, AUC, 0.89; accuracy, 0.82; precision, 0.91) than previous similar studies. ABSTRACT: A well-established lung-cancer-survival-prediction model that relies on multiple data types, multiple novel machine-learning algorithms, and external testing is absent in the literature. This study aims to address this gap and determine the critical factors of lung cancer survival. We selected non-small-cell lung cancer patients from a retrospective dataset of the Taipei Medical University Clinical Research Database and Taiwan Cancer Registry between January 2008 and December 2018. All patients were monitored from the index date of cancer diagnosis until the event of death. Variables, including demographics, comorbidities, medications, laboratories, and patient gene tests, were used. Nine machine-learning algorithms with various modes were used. The performance of the algorithms was measured by the area under the receiver operating characteristic curve (AUC). In total, 3714 patients were included. The best performance of the artificial neural network (ANN) model was achieved when integrating all variables with the AUC, accuracy, precision, recall, and F1-score of 0.89, 0.82, 0.91, 0.75, and 0.65, respectively. The most important features were cancer stage, cancer size, age of diagnosis, smoking, drinking status, EGFR gene, and body mass index. Overall, the ANN model improved predictive performance when integrating different data types.