Comparison of nomogram with machine learning techniques for prediction of overall survival in patients with tongue cancer

• Published in: International journal of medical informatics (Shannon, Ireland) Ireland), 2021-01, Vol.145, p.104313-104313, Article 104313
• Main Authors: Alabi, Rasheed Omobolaji, Mäkitie, Antti A., Pirinen, Matti, Elmusrati, Mohammed, Leivo, Ilmo, Almangush, Alhadi
• Format: Article
• Language: English
• Subjects: Bayes Theorem; Humans; Machine Learning; Medicin och hälsovetenskap; Nomogram; Nomograms; overall survival; Predict; Support Vector Machine; tongue cancer; Tongue Neoplasms
• ISSN: 1386-5056; 1872-8243; 1872-8243
• DOI: 10.1016/j.ijmedinf.2020.104313

•What we already know on the topic:•Nomogram can be used to estimate the overall survival in cancer patients.•Machine learning techniques have been used to predict the overall survival in tongue cancer patients.•What knowledge this study adds:•To the best of our knowledge, this is the first study that compared the performance of a nomogram with machine learning techniques to estimate overall survival in tongue cancer patients.•The machine learning model outperformed the nomogram in estimating patients’ outcome.•We proposed a combination of a nomogram – machine learning (NomoML) predictive model to improve care for tongue cancer patients.•Improved decision-making by the clinician and improved the overall quality of care of the patients. The prediction of overall survival in tongue cancer is important for planning of personalized care and patient counselling. This study compares the performance of a nomogram with a machine learning model to predict overall survival in tongue cancer. The nomogram and machine learning model were built using a large data set from the Surveillance, Epidemiology, and End Results (SEER) program database. The comparison is necessary to provide the clinicians with a comprehensive, practical, and most accurate assistive system to predict overall survival of this patient population. The data set used included the records of 7596 tongue cancer patients. The considered machine learning algorithms were logistic regression, support vector machine, Bayes point machine, boosted decision tree, decision forest, and decision jungle. These algorithms were mainly evaluated in terms of the areas under the receiver-operating characteristic (ROC) curve (AUC) and accuracy values. The performance of the algorithm that produced the best result was compared with a nomogram to predict overall survival in tongue cancer patients. The boosted decision-tree algorithm outperformed other algorithms. When compared with a nomogram using external validation data, the boosted decision tree produced an accuracy of 88.7% while the nomogram showed an accuracy of 60.4%. In addition, it was found that age of patient, T stage, radiotherapy, and the surgical resection were the most prominent features with significant influence on the machine learning model’s performance to predict overall survival. The machine learning model provides more personalized and reliable prognostic information of tongue cancer than the nomogram. However, the level of transparency offered by th