首页 > 最新文献

medRxiv - Surgery最新文献

英文 中文
EndoGPT: A Proof-of-concept Large Language Model Based Assistant for the Management of Thyroid Nodules EndoGPT:基于大语言模型的甲状腺结节管理助手的概念验证
Pub Date : 2024-05-31 DOI: 10.1101/2024.05.29.24308002
Meghal Shah, Eric J. Kuo, Jennifer H. Kuo, Shawn Hsu, Catherine McManus, Rachel Liou, James A. Lee, Tejas S. Sathe
Large language models (LLMs) are increasingly being explored for their potential to simulate clinical reasoning. Here, we demonstrate our initial experience using the GPT-4o LLM along with prompt engineering and knowledge retrieval to develop EndoGPT, a clinical decision support tool for the management of thyroid nodules. In a pilot study of 50 cases, EndoGPT demonstrated an 83% concordance rate with expert surgeons’ assessments and plans. The highest concordance was in diagnosis (93%), followed by the need for an operation (82%) and type of operation (69%). This work suggests that LLM-based assistants may play a useful role in assisting clinicians in the future.
大型语言模型(LLM)在模拟临床推理方面的潜力正日益受到人们的关注。在这里,我们展示了使用 GPT-4o LLM 以及提示工程和知识检索来开发 EndoGPT 的初步经验,这是一种用于甲状腺结节管理的临床决策支持工具。在对 50 个病例的试点研究中,EndoGPT 与专家外科医生的评估和计划的吻合率高达 83%。一致性最高的是诊断(93%),其次是手术需求(82%)和手术类型(69%)。这项工作表明,基于 LLM 的助手在未来协助临床医生方面可能会发挥有益的作用。
{"title":"EndoGPT: A Proof-of-concept Large Language Model Based Assistant for the Management of Thyroid Nodules","authors":"Meghal Shah, Eric J. Kuo, Jennifer H. Kuo, Shawn Hsu, Catherine McManus, Rachel Liou, James A. Lee, Tejas S. Sathe","doi":"10.1101/2024.05.29.24308002","DOIUrl":"https://doi.org/10.1101/2024.05.29.24308002","url":null,"abstract":"Large language models (LLMs) are increasingly being explored for their potential to simulate clinical reasoning. Here, we demonstrate our initial experience using the GPT-4o LLM along with prompt engineering and knowledge retrieval to develop EndoGPT, a clinical decision support tool for the management of thyroid nodules. In a pilot study of 50 cases, EndoGPT demonstrated an 83% concordance rate with expert surgeons’ assessments and plans. The highest concordance was in diagnosis (93%), followed by the need for an operation (82%) and type of operation (69%). This work suggests that LLM-based assistants may play a useful role in assisting clinicians in the future.","PeriodicalId":501051,"journal":{"name":"medRxiv - Surgery","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141257981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Protocol for the Development of Artificial Intelligence Models for the Reduction of Surgical Complications Based on Intraoperative Video - Surg_Cloud project 基于术中视频减少手术并发症的人工智能模型开发协议 - Surg_Cloud 项目
Pub Date : 2024-05-27 DOI: 10.1101/2024.05.26.24307908
Antonio Sampaio Soares, Sophia Bano, Laura T Castro, Ricardo Rocha, Paulo Alves, Paulo Mira, João Costa, Manish Chand, Danail Stoyanov
Introduction Complications following abdominal surgery have a very significant negative impact on the patient and the health care system. Despite the spread of minimally invasive surgery, there is no automated way to use intraoperative video to predict complications. New developments in data storage capacity and artificial intelligence algorithm creation now allow for this opportunity.
导言:腹部手术后的并发症对患者和医疗系统都有非常大的负面影响。尽管微创手术已经普及,但目前还没有使用术中视频预测并发症的自动化方法。现在,数据存储容量和人工智能算法的新发展为我们提供了这一机会。
{"title":"Protocol for the Development of Artificial Intelligence Models for the Reduction of Surgical Complications Based on Intraoperative Video - Surg_Cloud project","authors":"Antonio Sampaio Soares, Sophia Bano, Laura T Castro, Ricardo Rocha, Paulo Alves, Paulo Mira, João Costa, Manish Chand, Danail Stoyanov","doi":"10.1101/2024.05.26.24307908","DOIUrl":"https://doi.org/10.1101/2024.05.26.24307908","url":null,"abstract":"<strong>Introduction</strong> Complications following abdominal surgery have a very significant negative impact on the patient and the health care system. Despite the spread of minimally invasive surgery, there is no automated way to use intraoperative video to predict complications. New developments in data storage capacity and artificial intelligence algorithm creation now allow for this opportunity.","PeriodicalId":501051,"journal":{"name":"medRxiv - Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141167011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and safety of ethanolamine oleate in sclerotherapy in patients with difficult-to-resect venous malformations: A multicenter, open-label, single-arm study 油酸乙醇胺对难以切除的静脉畸形患者进行硬化疗法的有效性和安全性:一项多中心、开放标签、单臂研究
Pub Date : 2024-05-09 DOI: 10.1101/2024.05.06.24306216
Mine Ozaki, Tadashi Nomura, Keigo Osuga, Masakazu Kurita, Ayato Hayashi, Shunsuke Yuzuriha, Noriko Aramaki-Hattori, Makoto Hikosaka, Taiki Nozaki, Michio Ozeki, Junko Ochi, Shimpei Akiyama, Yasumasa Kakei, Keiko Miyakoda, Naoko Kashiwagi, Takahiro Yasuda, Yuki Iwashina, Tsuyoshi Kaneko, Kiyoko Kamibeppu, Takafumi Soejima, Kiyonori Harii
Objective To evaluate the efficacy and safety of sclerotherapy in patients with difficult-to-resect venous malformations treated with ethanolamine oleate.
目的 评估使用油酸乙醇胺治疗难以切除的静脉畸形患者的硬化疗法的疗效和安全性。
{"title":"Efficacy and safety of ethanolamine oleate in sclerotherapy in patients with difficult-to-resect venous malformations: A multicenter, open-label, single-arm study","authors":"Mine Ozaki, Tadashi Nomura, Keigo Osuga, Masakazu Kurita, Ayato Hayashi, Shunsuke Yuzuriha, Noriko Aramaki-Hattori, Makoto Hikosaka, Taiki Nozaki, Michio Ozeki, Junko Ochi, Shimpei Akiyama, Yasumasa Kakei, Keiko Miyakoda, Naoko Kashiwagi, Takahiro Yasuda, Yuki Iwashina, Tsuyoshi Kaneko, Kiyoko Kamibeppu, Takafumi Soejima, Kiyonori Harii","doi":"10.1101/2024.05.06.24306216","DOIUrl":"https://doi.org/10.1101/2024.05.06.24306216","url":null,"abstract":"<strong>Objective</strong> To evaluate the efficacy and safety of sclerotherapy in patients with difficult-to-resect venous malformations treated with ethanolamine oleate.","PeriodicalId":501051,"journal":{"name":"medRxiv - Surgery","volume":"130 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140930313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Protocol for assessing the impact of the 6th National Audit Project recommendations on practice 第六次国家审计项目建议对实践影响的评估规程
Pub Date : 2024-05-04 DOI: 10.1101/2024.05.03.24306350
Sigrún Eyrúnardóttir Clark, Iain Moppett, S. Ramani Moonesinghe, Cecilia Vindrola-Padros
Patient safety has been a growing area of concern, especially within perioperative care where risks of major complications during surgery exist. Anaphylaxis in the operating theatre is a life-threatening drug reaction that happens suddenly, without warning and can affect anyone. The 6th National Audit Project (NAP6) of the Royal College of Anaesthetists (RCoA): Perioperative Anaphylaxis was the largest ever prospective study of anaphylaxis related to anaesthesia and surgery. The findings from the audit were collated into a report and included recommendations for improved patient care. The purpose of this study is to understand the perceptions of the NAP6 recommendations and their impact on practice. This study will use ethnographic qualitative methods in the form of observations, interviews and a documentary analysis. The sessions targeted for observations will include departmental or hospital meetings, and educational or training sessions, related to perioperative anaphylaxis. The target sample size of 78 healthcare professionals across six hospitals within England, will include individuals with roles specific to anaesthesia, surgery, immunology, allergy and governance. Additionally, six stakeholders will be interviewed who can provide insights into the NAP6 recommendations at the national level. Across the six sites, local collaborators will share any relevant documents related to perioperative anaphylaxis or the NAP-6 recommendations. The study has received regulatory approvals from the Health Research Authority and has been funded by the National Institute for Health and Care Research.
患者安全一直是人们日益关注的问题,尤其是在围手术期护理中,因为手术期间存在发生重大并发症的风险。手术室中的过敏性休克是一种危及生命的药物反应,会在毫无征兆的情况下突然发生,任何人都可能受到影响。英国皇家麻醉师学院 (RCoA) 的第六次全国审计项目 (NAP6):围术期过敏性休克是有史以来规模最大的与麻醉和手术相关的过敏性休克前瞻性研究。审计结果被整理成一份报告,其中包括改善患者护理的建议。本研究旨在了解人们对 NAP6 建议的看法及其对实践的影响。本研究将采用观察、访谈和文献分析等人种学定性方法。观察对象包括与围手术期过敏性休克相关的部门或医院会议、教育或培训课程。目标样本量为英格兰六家医院的 78 名医护人员,其中包括麻醉、手术、免疫学、过敏和管理方面的专业人员。此外,还将对六名利益相关者进行访谈,他们可以为国家层面的 NAP6 建议提供见解。在这六个地点,当地合作者将共享与围术期过敏性休克或 NAP-6 建议相关的任何文件。该研究已获得卫生研究局的监管批准,并得到了国家卫生与护理研究所的资助。
{"title":"Protocol for assessing the impact of the 6th National Audit Project recommendations on practice","authors":"Sigrún Eyrúnardóttir Clark, Iain Moppett, S. Ramani Moonesinghe, Cecilia Vindrola-Padros","doi":"10.1101/2024.05.03.24306350","DOIUrl":"https://doi.org/10.1101/2024.05.03.24306350","url":null,"abstract":"Patient safety has been a growing area of concern, especially within perioperative care where risks of major complications during surgery exist. Anaphylaxis in the operating theatre is a life-threatening drug reaction that happens suddenly, without warning and can affect anyone. The 6th National Audit Project (NAP6) of the Royal College of Anaesthetists (RCoA): Perioperative Anaphylaxis was the largest ever prospective study of anaphylaxis related to anaesthesia and surgery. The findings from the audit were collated into a report and included recommendations for improved patient care. The purpose of this study is to understand the perceptions of the NAP6 recommendations and their impact on practice. This study will use ethnographic qualitative methods in the form of observations, interviews and a documentary analysis. The sessions targeted for observations will include departmental or hospital meetings, and educational or training sessions, related to perioperative anaphylaxis. The target sample size of 78 healthcare professionals across six hospitals within England, will include individuals with roles specific to anaesthesia, surgery, immunology, allergy and governance. Additionally, six stakeholders will be interviewed who can provide insights into the NAP6 recommendations at the national level. Across the six sites, local collaborators will share any relevant documents related to perioperative anaphylaxis or the NAP-6 recommendations. The study has received regulatory approvals from the Health Research Authority and has been funded by the National Institute for Health and Care Research.","PeriodicalId":501051,"journal":{"name":"medRxiv - Surgery","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140930392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
DNA methylation in pituitary adenomas: scoping review protocol 垂体腺瘤中的 DNA 甲基化:范围审查协议
Pub Date : 2024-04-29 DOI: 10.1101/2024.04.29.24306412
Morten Winkler Møller, Mathias Just Nortvig, Mikkel Schou Andersen, Frantz Rom Poulsen
Objective The general objective of this study is to map the current knowledge in DNA methylation in Pituitary Adenomas, and in particular focus on genetic and epigenetic findings and the translation into a clinical setting.
目标 本研究的总体目标是绘制垂体腺瘤 DNA 甲基化的现有知识图谱,尤其侧重于遗传学和表观遗传学研究结果,并将其转化为临床应用。
{"title":"DNA methylation in pituitary adenomas: scoping review protocol","authors":"Morten Winkler Møller, Mathias Just Nortvig, Mikkel Schou Andersen, Frantz Rom Poulsen","doi":"10.1101/2024.04.29.24306412","DOIUrl":"https://doi.org/10.1101/2024.04.29.24306412","url":null,"abstract":"<strong>Objective</strong> The general objective of this study is to map the current knowledge in DNA methylation in Pituitary Adenomas, and in particular focus on genetic and epigenetic findings and the translation into a clinical setting.","PeriodicalId":501051,"journal":{"name":"medRxiv - Surgery","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140830381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A roadmap for implanting microelectrode arrays to evoke tactile sensations through intracortical microstimulation 通过皮层内微刺激唤起触觉的微电极阵列植入路线图
Pub Date : 2024-04-28 DOI: 10.1101/2024.04.26.24306239
John E Downey, Hunter R Schone, Stephen T Foldes, Charles Greenspon, Fang Liu, Ceci Verbaarschot, Daniel Biro, David Satzer, Chan Hong Moon, Brian A Coffman, Vahab Youssofzadeh, Daryl Fields, Taylor G Hobbs, Elizaveta Okorokova, Elizabeth C Tyler-Kabara, Peter C Warnke, Jorge Gonzalez-Martinez, Nicholas G Hatsopoulos, Sliman J Bensmaia, Michael L Boninger, Robert A Gaunt, Jennifer L Collinger
Intracortical microstimulation (ICMS) is a method for restoring sensation to people with paralysis as part of a bidirectional brain-computer interface to restore upper limb function. Evoking tactile sensations of the hand through ICMS requires precise targeting of implanted electrodes. Here we describe the presurgical imaging procedures used to generate functional maps of the hand area of the somatosensory cortex and subsequent planning that guided the implantation of intracortical microelectrode arrays. In five participants with cervical spinal cord injury, across two study locations, this procedure successfully enabled ICMS-evoked sensations localized to at least the first four digits of the hand. The imaging and planning procedures developed through this clinical trial provide a roadmap for other brain-computer interface studies to ensure successful placement of stimulation electrodes.
皮层内微刺激(ICMS)是一种恢复瘫痪患者感觉的方法,是恢复上肢功能的双向脑机接口的一部分。通过 ICMS 唤醒手部触觉需要对植入电极进行精确定位。在此,我们介绍了用于生成躯体感觉皮层手部区域功能图的术前成像程序,以及指导皮层内微电极阵列植入的后续规划。在两个研究地点的五名颈部脊髓损伤患者中,该程序成功地使 ICMS 诱发的感觉定位到至少手部的前四位数字。通过该临床试验开发的成像和规划程序为其他脑机接口研究提供了路线图,以确保成功放置刺激电极。
{"title":"A roadmap for implanting microelectrode arrays to evoke tactile sensations through intracortical microstimulation","authors":"John E Downey, Hunter R Schone, Stephen T Foldes, Charles Greenspon, Fang Liu, Ceci Verbaarschot, Daniel Biro, David Satzer, Chan Hong Moon, Brian A Coffman, Vahab Youssofzadeh, Daryl Fields, Taylor G Hobbs, Elizaveta Okorokova, Elizabeth C Tyler-Kabara, Peter C Warnke, Jorge Gonzalez-Martinez, Nicholas G Hatsopoulos, Sliman J Bensmaia, Michael L Boninger, Robert A Gaunt, Jennifer L Collinger","doi":"10.1101/2024.04.26.24306239","DOIUrl":"https://doi.org/10.1101/2024.04.26.24306239","url":null,"abstract":"Intracortical microstimulation (ICMS) is a method for restoring sensation to people with paralysis as part of a bidirectional brain-computer interface to restore upper limb function. Evoking tactile sensations of the hand through ICMS requires precise targeting of implanted electrodes. Here we describe the presurgical imaging procedures used to generate functional maps of the hand area of the somatosensory cortex and subsequent planning that guided the implantation of intracortical microelectrode arrays. In five participants with cervical spinal cord injury, across two study locations, this procedure successfully enabled ICMS-evoked sensations localized to at least the first four digits of the hand. The imaging and planning procedures developed through this clinical trial provide a roadmap for other brain-computer interface studies to ensure successful placement of stimulation electrodes.","PeriodicalId":501051,"journal":{"name":"medRxiv - Surgery","volume":"155 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140830375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ALLIANCE A022104/NRG-GI010: The Janus Rectal Cancer Trial: a randomized phase II/III trial testing the efficacy of triplet versus doublet chemotherapy regarding clinical complete response and disease-free survival in patients with locally advanced rectal cancer Alliance A022104/NRG-GI010:Janus直肠癌试验:一项随机II/III期试验,测试三联化疗与二联化疗对局部晚期直肠癌患者临床完全反应和无病生存期的疗效
Pub Date : 2024-04-27 DOI: 10.1101/2024.04.25.24306396
J Alvarez, Q Shi, A Dasari, J Garcia-Aguilar, H Sanoff, TJ George, TS Hong, G Yothers, PA Philip, GD Nelson, T Al Baghdadi, O Alese, W Zambare, DM Omer, FS Verheij, J Buckley, H Williams, M George, R Garcia, EM O’Reilly, JA Meyerhardt, A Shergill, N Horvat, PB Romesser, WA Hall, JJ Smith
Background Recent data have demonstrated that in locally advanced rectal cancer (LARC), a total neoadjuvant therapy (TNT) approach improves compliance with chemotherapy and increases rates of tumor response compared to neoadjuvant chemoradiation (CRT) alone. They further indicate that the optimal sequencing of TNT involves consolidation (rather than induction) chemotherapy to optimize complete response rates. Data, largely from retrospective studies, have also shown that patients with clinical complete response (cCR) after neoadjuvant therapy may be managed safely with the watch and wait approach (WW) instead of preemptive total mesorectal resection (TME). However, the optimal consolidation chemotherapy regimen to achieve cCR has not been established, and a randomized clinical trial has not robustly evaluated cCR as a primary endpoint. Collaborating with a multidisciplinary oncology team and patient groups, we designed this NCI-sponsored study of chemotherapy intensification to address these issues and to drive up cCR rates, to provide opportunity for organ preservation, improve quality of life for patients and improve survival outcomes.
背景 最近的数据表明,对于局部晚期直肠癌(LARC),与单纯新辅助化放疗(CRT)相比,全新药辅助治疗(TNT)可提高化疗依从性并增加肿瘤反应率。他们进一步指出,TNT的最佳排序包括巩固(而非诱导)化疗,以优化完全反应率。主要来自回顾性研究的数据还显示,新辅助治疗后出现临床完全反应(cCR)的患者可以采用观察和等待方法(WW)进行安全管理,而不是进行先发制人的全直肠系膜切除术(TME)。然而,实现 cCR 的最佳巩固化疗方案尚未确定,随机临床试验也未将 cCR 作为主要终点进行有力评估。我们与多学科肿瘤学团队和患者团体合作,设计了这项由 NCI 赞助的化疗强化研究,以解决这些问题并提高 cCR 率,从而提供器官保留的机会、改善患者的生活质量并提高生存率。
{"title":"ALLIANCE A022104/NRG-GI010: The Janus Rectal Cancer Trial: a randomized phase II/III trial testing the efficacy of triplet versus doublet chemotherapy regarding clinical complete response and disease-free survival in patients with locally advanced rectal cancer","authors":"J Alvarez, Q Shi, A Dasari, J Garcia-Aguilar, H Sanoff, TJ George, TS Hong, G Yothers, PA Philip, GD Nelson, T Al Baghdadi, O Alese, W Zambare, DM Omer, FS Verheij, J Buckley, H Williams, M George, R Garcia, EM O’Reilly, JA Meyerhardt, A Shergill, N Horvat, PB Romesser, WA Hall, JJ Smith","doi":"10.1101/2024.04.25.24306396","DOIUrl":"https://doi.org/10.1101/2024.04.25.24306396","url":null,"abstract":"<strong>Background</strong> Recent data have demonstrated that in locally advanced rectal cancer (LARC), a total neoadjuvant therapy (TNT) approach improves compliance with chemotherapy and increases rates of tumor response compared to neoadjuvant chemoradiation (CRT) alone. They further indicate that the optimal sequencing of TNT involves consolidation (rather than induction) chemotherapy to optimize complete response rates. Data, largely from retrospective studies, have also shown that patients with clinical complete response (cCR) after neoadjuvant therapy may be managed safely with the watch and wait approach (WW) instead of preemptive total mesorectal resection (TME). However, the optimal consolidation chemotherapy regimen to achieve cCR has not been established, and a randomized clinical trial has not robustly evaluated cCR as a primary endpoint. Collaborating with a multidisciplinary oncology team and patient groups, we designed this NCI-sponsored study of chemotherapy intensification to address these issues and to drive up cCR rates, to provide opportunity for organ preservation, improve quality of life for patients and improve survival outcomes.","PeriodicalId":501051,"journal":{"name":"medRxiv - Surgery","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140830374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advancing 90-day mortality and anastomotic leakage predictions after oesophagectomy for cancer using explainable AI (XAI) 利用可解释人工智能(XAI)推进癌症食管切除术后 90 天死亡率和吻合口漏的预测工作
Pub Date : 2024-04-10 DOI: 10.1101/2024.04.09.24305451
Sebastian Djerf, Oscar Åkesson, Magnus Nilsson, Mats Lindblad, Jakob Hedberg, Jan Johansson, Attila Frigyesi
Oesophagectomy for cancer of the oesophagus carries significant morbidity and mortality. Ninety-day mortality and anastomosis leakage are critical early postoperative problems traditionally analysed through logistic regression. In this study, we challenge traditional logistic regression models to predict results with new explainable AI (XAI) models. We used the Swedish National Quality Register for Oesophageal and Gastric Cancer (NREV) to perform traditional multivariable logistic regression and XAI. The 90-day mortality was 6.0%, while anastomosis leakage was present in 12.4%. The XAI models yielded an area under the curve (AUC) of 0.91 for 90-day mortality (as compared with 0.84 for logistic regression). For anastomosis leakage, the AUC was 0.84 using XAI (0.74 using logistic regression). We show that age (mortality increases sharply after 55 years) and body mass index (BMI) (lowest mortality for BMI 30 kg/m2) are important survival factors. Additionally, we show that surgery time (minimum anastomosis leakage for a surgery time of 200 min to sharply increase to a maximum at 375 min) and BMI (the lower the BMI, the less anastomosis leakage) are important factors for anastomosis leakage. The surgical understanding of anastomosis leakage and mortality after oesophagectomy is advanced by judiciously applying XAI to structured data. Our nationwide oesophagectomy data contains significant nonlinear relationships. With the help of XAI, we extract personalised knowledge, bringing oesophagus surgery one step closer to personalised medicine.
食道癌食道切除术的发病率和死亡率都很高。九十天死亡率和吻合口漏是传统上通过逻辑回归分析的术后早期关键问题。在这项研究中,我们采用新的可解释人工智能(XAI)模型来预测结果,对传统的逻辑回归模型提出了挑战。我们利用瑞典国家食管癌和胃癌质量登记册(NREV)进行了传统的多变量逻辑回归和 XAI 分析。90天死亡率为6.0%,吻合口漏率为12.4%。XAI 模型的 90 天死亡率曲线下面积 (AUC) 为 0.91(逻辑回归为 0.84)。对于吻合口漏,XAI 的 AUC 为 0.84(逻辑回归为 0.74)。我们发现,年龄(55 岁以后死亡率急剧上升)和体重指数(BMI)(BMI 为 30 kg/m2 时死亡率最低)是重要的生存因素。此外,我们还发现手术时间(手术时间为 200 分钟时吻合口漏最少,375 分钟时吻合口漏最多)和体重指数(体重指数越低,吻合口漏越少)是影响吻合口漏的重要因素。通过对结构化数据明智地应用 XAI,可促进对食管切除术后吻合口漏和死亡率的外科理解。我们的全国食道切除术数据包含重要的非线性关系。在 XAI 的帮助下,我们提取出了个性化知识,使食道外科离个性化医疗更近了一步。
{"title":"Advancing 90-day mortality and anastomotic leakage predictions after oesophagectomy for cancer using explainable AI (XAI)","authors":"Sebastian Djerf, Oscar Åkesson, Magnus Nilsson, Mats Lindblad, Jakob Hedberg, Jan Johansson, Attila Frigyesi","doi":"10.1101/2024.04.09.24305451","DOIUrl":"https://doi.org/10.1101/2024.04.09.24305451","url":null,"abstract":"Oesophagectomy for cancer of the oesophagus carries significant morbidity and mortality. Ninety-day mortality and anastomosis leakage are critical early postoperative problems traditionally analysed through logistic regression. In this study, we challenge traditional logistic regression models to predict results with new explainable AI (XAI) models. We used the Swedish National Quality Register for Oesophageal and Gastric Cancer (NREV) to perform traditional multivariable logistic regression and XAI. The 90-day mortality was 6.0%, while anastomosis leakage was present in 12.4%. The XAI models yielded an area under the curve (AUC) of 0.91 for 90-day mortality (as compared with 0.84 for logistic regression). For anastomosis leakage, the AUC was 0.84 using XAI (0.74 using logistic regression). We show that age (mortality increases sharply after 55 years) and body mass index (BMI) (lowest mortality for BMI 30 kg/m<sup>2</sup>) are important survival factors. Additionally, we show that surgery time (minimum anastomosis leakage for a surgery time of 200 min to sharply increase to a maximum at 375 min) and BMI (the lower the BMI, the less anastomosis leakage) are important factors for anastomosis leakage. The surgical understanding of anastomosis leakage and mortality after oesophagectomy is advanced by judiciously applying XAI to structured data. Our nationwide oesophagectomy data contains significant nonlinear relationships. With the help of XAI, we extract personalised knowledge, bringing oesophagus surgery one step closer to personalised medicine.","PeriodicalId":501051,"journal":{"name":"medRxiv - Surgery","volume":"103 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140598694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Seasonal Variations and the Associated Factors of Acute Appendicitis at a Tertiary Hospital: A Case of SPHMMC, Addis Ababa, Ethiopia 一家三级医院急性阑尾炎的季节变化及相关因素:埃塞俄比亚亚的斯亚贝巴 SPHMMC 病例
Pub Date : 2024-04-09 DOI: 10.1101/2024.04.06.24305309
Lohide Daniel, Fekadu Negash
Background Acute appendicitis, a surgical emergency, is a prevalent pathology with uncertain etiology, influenced by various factors and seasonal variations.
背景 急性阑尾炎是外科急症,是一种病因不明的常见病,受各种因素和季节变化的影响。
{"title":"Seasonal Variations and the Associated Factors of Acute Appendicitis at a Tertiary Hospital: A Case of SPHMMC, Addis Ababa, Ethiopia","authors":"Lohide Daniel, Fekadu Negash","doi":"10.1101/2024.04.06.24305309","DOIUrl":"https://doi.org/10.1101/2024.04.06.24305309","url":null,"abstract":"<strong>Background</strong> Acute appendicitis, a surgical emergency, is a prevalent pathology with uncertain etiology, influenced by various factors and seasonal variations.","PeriodicalId":501051,"journal":{"name":"medRxiv - Surgery","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140598692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Teaching Uncommon Diseases in Surgery: Conceptual Framework for the Development of a Peritoneal Surface Malignancy Curriculum 外科常见病教学:腹膜表面恶性肿瘤课程开发的概念框架
Pub Date : 2024-04-08 DOI: 10.1101/2024.04.06.24305431
Frederick A Godley, Varun V Bansal, David G. Su, Vadim Gushchin, Mecker G Moller, Rupen Shah, Alexandra Gangi, Deepa Magge, Dan G Blazer, Oliver S Eng, Laura Lambert, Sean Dineen, Sherif Abdel-Misih, John Encandela, Kiran K Turaga
Background There is a critical need for contemporary education to address peritoneal surface malignancies (PSM). This study delineates the development of an online PSM curriculum for surgical trainees, in conjunction with a national consortium.
背景 现在急需针对腹膜表面恶性肿瘤(PSM)的现代教育。本研究描述了与一个国家联盟合作为外科学员开发的在线 PSM 课程。
{"title":"Teaching Uncommon Diseases in Surgery: Conceptual Framework for the Development of a Peritoneal Surface Malignancy Curriculum","authors":"Frederick A Godley, Varun V Bansal, David G. Su, Vadim Gushchin, Mecker G Moller, Rupen Shah, Alexandra Gangi, Deepa Magge, Dan G Blazer, Oliver S Eng, Laura Lambert, Sean Dineen, Sherif Abdel-Misih, John Encandela, Kiran K Turaga","doi":"10.1101/2024.04.06.24305431","DOIUrl":"https://doi.org/10.1101/2024.04.06.24305431","url":null,"abstract":"<strong>Background</strong> There is a critical need for contemporary education to address peritoneal surface malignancies (PSM). This study delineates the development of an online PSM curriculum for surgical trainees, in conjunction with a national consortium.","PeriodicalId":501051,"journal":{"name":"medRxiv - Surgery","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140602213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
medRxiv - Surgery
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1