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Artificial intelligence assists surgeons’ decision-making of temporary ileostomy in patients with rectal cancer who have received anterior resection
Due to the difficult evaluation of the risk of anastomotic leakage (AL) after rectal cancer resection, the decision to perform a temporary ileostomy is not easily distinguishable. The aim of the present study was to develop an artificial intelligence (AI) model for identifying the risk of AL to assi...
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Published in: | European journal of surgical oncology 2023-02, Vol.49 (2), p.433-439 |
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creator | Shao, Shengli Zhao, Yufeng Lu, Qiyi Liu, Lu Mu, Lei Qin, Jichao |
description | Due to the difficult evaluation of the risk of anastomotic leakage (AL) after rectal cancer resection, the decision to perform a temporary ileostomy is not easily distinguishable. The aim of the present study was to develop an artificial intelligence (AI) model for identifying the risk of AL to assist surgeons in the selective implementation of a temporary ileostomy.
The data from 2240 patients with rectal cancer who received anterior resection were collected, and these patients were divided into one training and two test cohorts. Five AI algorithms, such as support vector machine (SVM), logistic regression (LR), Naive Bayes (NB), stochastic gradient descent (SGD) and random forest (RF) were employed to develop predictive models using clinical variables and were assessed using the two test cohorts.
The SVM model indicated good discernment of AL, and might have increased the implementation of temporary ileostomy in patients with AL in the training cohort (p |
doi_str_mv | 10.1016/j.ejso.2022.09.020 |
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The data from 2240 patients with rectal cancer who received anterior resection were collected, and these patients were divided into one training and two test cohorts. Five AI algorithms, such as support vector machine (SVM), logistic regression (LR), Naive Bayes (NB), stochastic gradient descent (SGD) and random forest (RF) were employed to develop predictive models using clinical variables and were assessed using the two test cohorts.
The SVM model indicated good discernment of AL, and might have increased the implementation of temporary ileostomy in patients with AL in the training cohort (p < 0.001). Following the assessment of the two test cohorts, the SVM model could identify AL in a favorable manner, which performed with positive predictive values of 0.150 (0.091–0.234) and 0.151 (0.091–0.237), and negative predictive values of 0.977 (0.958–0.988) and 0.986 (0.969–0.994), respectively. It is important to note that the implementation of temporary ileostomy in patients without AL would have been significantly reduced (p < 0.001) and which would have been significantly increased in patients with AL (p < 0.05).
The model (https://alrisk.21cloudbox.com/) indicated good discernment of AL, which may be used to assist the surgeon's decision-making of performing temporary ileostomy.</description><identifier>ISSN: 0748-7983</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1016/j.ejso.2022.09.020</identifier><identifier>PMID: 36244844</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Anastomosis, Surgical ; Anastomotic Leak - surgery ; Anastomotic leakage ; Artificial Intelligence ; Bayes Theorem ; Humans ; Ileostomy ; Rectal cancer ; Rectal Neoplasms - surgery ; Retrospective Studies ; Surgeons ; Temporary ileostomy</subject><ispartof>European journal of surgical oncology, 2023-02, Vol.49 (2), p.433-439</ispartof><rights>2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology</rights><rights>Copyright © 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-deee3bfb086b75c1d2b8869e69a2316fe50e318b3bf1fac496e7cef4d5aeb07b3</citedby><cites>FETCH-LOGICAL-c356t-deee3bfb086b75c1d2b8869e69a2316fe50e318b3bf1fac496e7cef4d5aeb07b3</cites><orcidid>0000-0002-2961-7624</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36244844$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shao, Shengli</creatorcontrib><creatorcontrib>Zhao, Yufeng</creatorcontrib><creatorcontrib>Lu, Qiyi</creatorcontrib><creatorcontrib>Liu, Lu</creatorcontrib><creatorcontrib>Mu, Lei</creatorcontrib><creatorcontrib>Qin, Jichao</creatorcontrib><title>Artificial intelligence assists surgeons’ decision-making of temporary ileostomy in patients with rectal cancer who have received anterior resection</title><title>European journal of surgical oncology</title><addtitle>Eur J Surg Oncol</addtitle><description>Due to the difficult evaluation of the risk of anastomotic leakage (AL) after rectal cancer resection, the decision to perform a temporary ileostomy is not easily distinguishable. The aim of the present study was to develop an artificial intelligence (AI) model for identifying the risk of AL to assist surgeons in the selective implementation of a temporary ileostomy.
The data from 2240 patients with rectal cancer who received anterior resection were collected, and these patients were divided into one training and two test cohorts. Five AI algorithms, such as support vector machine (SVM), logistic regression (LR), Naive Bayes (NB), stochastic gradient descent (SGD) and random forest (RF) were employed to develop predictive models using clinical variables and were assessed using the two test cohorts.
The SVM model indicated good discernment of AL, and might have increased the implementation of temporary ileostomy in patients with AL in the training cohort (p < 0.001). Following the assessment of the two test cohorts, the SVM model could identify AL in a favorable manner, which performed with positive predictive values of 0.150 (0.091–0.234) and 0.151 (0.091–0.237), and negative predictive values of 0.977 (0.958–0.988) and 0.986 (0.969–0.994), respectively. It is important to note that the implementation of temporary ileostomy in patients without AL would have been significantly reduced (p < 0.001) and which would have been significantly increased in patients with AL (p < 0.05).
The model (https://alrisk.21cloudbox.com/) indicated good discernment of AL, which may be used to assist the surgeon's decision-making of performing temporary ileostomy.</description><subject>Anastomosis, Surgical</subject><subject>Anastomotic Leak - surgery</subject><subject>Anastomotic leakage</subject><subject>Artificial Intelligence</subject><subject>Bayes Theorem</subject><subject>Humans</subject><subject>Ileostomy</subject><subject>Rectal cancer</subject><subject>Rectal Neoplasms - surgery</subject><subject>Retrospective Studies</subject><subject>Surgeons</subject><subject>Temporary ileostomy</subject><issn>0748-7983</issn><issn>1532-2157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kc9u1DAQhy0EokvhBTggH7kk-E8SJxKXqioUqRIXOFuOM9mdJYkXj3er3ngKJF6PJ8HRFo6cbI2--Y1mPsZeS1FKIZt3-xL2FEollCpFVwolnrCNrLUqlKzNU7YRpmoL07X6gr0g2gshOm265-xCN6qq2qrasJ9XMeGIHt3EcUkwTbiFxQN3REiJOB3jFsJCv3_84gN4JAxLMbtvuGx5GHmC-RCiiw8cJwiUwpx_Cz-4hLDk9ntMOx7Bp5zvXQ6O_H4X-M6dYC0DnmDgLg-OGGKuUEbzhJfs2egmgleP7yX7-uHmy_Vtcff546frq7vC67pJxQAAuh970Ta9qb0cVN-2TQdN55SWzQi1AC3bPjNydL7qGjAexmqoHfTC9PqSvT3nHmL4fgRKdkby-QpugXAkq4yqK921RmZUnVEfA1GE0R4iznlzK4Vdfdi9XX3Y1YcVnc0-ctObx_xjP8Pwr-WvgAy8PwOQtzwhREseVwEDrlezQ8D_5f8B41mi2g</recordid><startdate>202302</startdate><enddate>202302</enddate><creator>Shao, Shengli</creator><creator>Zhao, Yufeng</creator><creator>Lu, Qiyi</creator><creator>Liu, Lu</creator><creator>Mu, Lei</creator><creator>Qin, Jichao</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2961-7624</orcidid></search><sort><creationdate>202302</creationdate><title>Artificial intelligence assists surgeons’ decision-making of temporary ileostomy in patients with rectal cancer who have received anterior resection</title><author>Shao, Shengli ; Zhao, Yufeng ; Lu, Qiyi ; Liu, Lu ; Mu, Lei ; Qin, Jichao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-deee3bfb086b75c1d2b8869e69a2316fe50e318b3bf1fac496e7cef4d5aeb07b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anastomosis, Surgical</topic><topic>Anastomotic Leak - surgery</topic><topic>Anastomotic leakage</topic><topic>Artificial Intelligence</topic><topic>Bayes Theorem</topic><topic>Humans</topic><topic>Ileostomy</topic><topic>Rectal cancer</topic><topic>Rectal Neoplasms - surgery</topic><topic>Retrospective Studies</topic><topic>Surgeons</topic><topic>Temporary ileostomy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shao, Shengli</creatorcontrib><creatorcontrib>Zhao, Yufeng</creatorcontrib><creatorcontrib>Lu, Qiyi</creatorcontrib><creatorcontrib>Liu, Lu</creatorcontrib><creatorcontrib>Mu, Lei</creatorcontrib><creatorcontrib>Qin, Jichao</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shao, Shengli</au><au>Zhao, Yufeng</au><au>Lu, Qiyi</au><au>Liu, Lu</au><au>Mu, Lei</au><au>Qin, Jichao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Artificial intelligence assists surgeons’ decision-making of temporary ileostomy in patients with rectal cancer who have received anterior resection</atitle><jtitle>European journal of surgical oncology</jtitle><addtitle>Eur J Surg Oncol</addtitle><date>2023-02</date><risdate>2023</risdate><volume>49</volume><issue>2</issue><spage>433</spage><epage>439</epage><pages>433-439</pages><issn>0748-7983</issn><eissn>1532-2157</eissn><abstract>Due to the difficult evaluation of the risk of anastomotic leakage (AL) after rectal cancer resection, the decision to perform a temporary ileostomy is not easily distinguishable. The aim of the present study was to develop an artificial intelligence (AI) model for identifying the risk of AL to assist surgeons in the selective implementation of a temporary ileostomy.
The data from 2240 patients with rectal cancer who received anterior resection were collected, and these patients were divided into one training and two test cohorts. Five AI algorithms, such as support vector machine (SVM), logistic regression (LR), Naive Bayes (NB), stochastic gradient descent (SGD) and random forest (RF) were employed to develop predictive models using clinical variables and were assessed using the two test cohorts.
The SVM model indicated good discernment of AL, and might have increased the implementation of temporary ileostomy in patients with AL in the training cohort (p < 0.001). Following the assessment of the two test cohorts, the SVM model could identify AL in a favorable manner, which performed with positive predictive values of 0.150 (0.091–0.234) and 0.151 (0.091–0.237), and negative predictive values of 0.977 (0.958–0.988) and 0.986 (0.969–0.994), respectively. It is important to note that the implementation of temporary ileostomy in patients without AL would have been significantly reduced (p < 0.001) and which would have been significantly increased in patients with AL (p < 0.05).
The model (https://alrisk.21cloudbox.com/) indicated good discernment of AL, which may be used to assist the surgeon's decision-making of performing temporary ileostomy.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>36244844</pmid><doi>10.1016/j.ejso.2022.09.020</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-2961-7624</orcidid></addata></record> |
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subjects | Anastomosis, Surgical Anastomotic Leak - surgery Anastomotic leakage Artificial Intelligence Bayes Theorem Humans Ileostomy Rectal cancer Rectal Neoplasms - surgery Retrospective Studies Surgeons Temporary ileostomy |
title | Artificial intelligence assists surgeons’ decision-making of temporary ileostomy in patients with rectal cancer who have received anterior resection |
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