Machine learning and neurosurgical outcome prediction: a systematic review
Open accessAbstract
Objective Accurate measurement of surgical outcomes is highly desirable to optimize surgical decision-making. An important element of surgical decision making is identification of the patient cohort that will benefit from surgery before the intervention. Machine learning (ML) enables computers to learn from previous data to make accurate predictions on new data. In this systematic review, we evaluate the potential of ML for neurosurgical outcome prediction.Methods A systematic search in the PubMed and Embase databases was performed to identify all potential relevant studies up to January 1, 2017.Results Thirty studies were identified that evaluated ML algorithms used as prediction models for survival, recurrence, symptom improvement, and adverse events in patients undergoing surgery for epilepsy, brain tumor, spinal lesions, neurovascular disease, movement disorders, traumatic brain injury, and hydrocephalus. Depending on the specific prediction task evaluated and the type of input features included, ML models predicted outcomes after neurosurgery with a median accuracy and area under the receiver operating curve of 94.5% and 0.83, respectively. Compared with logistic regression, ML models performed significantly better and showed a median absolute improvement in accuracy and area under the receiver operating curve of 15% and 0.06, respectively. Some studies also demonstrated a better performance in ML models compared with established prognostic indices and clinical experts.Conclusions In the research setting, ML has been studied extensively, demonstrating an excellent performance in outcome prediction for a wide range of neurosurgical conditions. However, future studies should investigate how ML can be implemented as a practical tool supporting neurosurgical care.
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ML tools for optimizing care outcomes have been used in critical care for optimizing sepsis management, management of chronic conditions, and optimizing surgical outcomes.
“ML tools for optimizing care outcomes have been used in various settings, including critical care for optimizing sepsis management (27), management of chronic conditions (28), and optimizing surgical outcomes (29).”
From Accessing Artificial Intelligence for Clinical Decision-Making (2021) · cites this paper as [29]
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Self-citationArtificial Intelligence in Neurosurgery: A Bibliometric Analysis
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“, [17] systematically reviewed 30 publications that utilized machine learning approaches to predict mortality and other neurological outcomes following TBI.”
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Topics and trends in artificial intelligence assisted human brain research
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Machine Learning and Artificial Intelligence in Neurosurgery: Status, Prospects, and Challenges
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“Machine learning model assessment was performed through four different methods in concordance with the literature to provide a robust model assessment [34]: (1) discrimination (area under the receiver operating curve [AUC]), (2) calibration (calibration plot—intercept and slope), (3) Brier score, and (4) decision curv…”
MethodMachine learning applications in tobacco research: a scoping review
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“An apparent focus of these reviews is on supervised learning, including diagnosing and prognosing diseases using neuroimaging data, 11–14 predicting neurosurgical outcomes 15 and forecasting population health-related outcomes.”
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Diagnostic Accuracy of Machine Learning Models to Identify Congenital Heart Disease: A Meta-Analysis
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“Useofarti fi cial intelligence (AI) in healthcare and its utility in medicine, from diagnosis and risk assessment to outcome predictions for a wide variety of illnesses has been extensively described in the literature (Koivu et al., 2018; Senders et al., 2018; Harris et al., 2019).”
BackgroundBiosensors for Epilepsy Management: State-of-Art and Future Aspects
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Machine learning-enabled multiplexed microfluidic sensors
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Using an artificial neural network to predict traumatic brain injury
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In Reply: Big Data Research in Neurosurgery: A Critical Look at this Popular New Study Design
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Prediction of mortality following pediatric heart transplant using machine learning algorithms
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The Use of Machine Learning for Predicting Complications of Free-Flap Head and Neck Reconstruction
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“This gap in the literature is coherent across a wide range of medical specialties and diseases, including trauma [9], cancer [11], neurosurgery [10], depression [12], acute gastrointestinal bleeding [13], sepsis [14], acute liver failure [15], ischemic stroke [16], thermal injury [17], and…”
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“A great deal of enthusiasm has been shown for machine learning, as it has demonstrated exceptional performance in a variety of tasks including predicting the outcome of individuals following certain medical interventions, interpreting diagnostic images, and assessing the meaning of open-text passages [17-20].”
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“Accuracy refers to the proportion of correct predictions among the total number of predictions, and AUC corresponds to the probability that a binary classifier will rank a randomly chosen positive instance higher than a randomly chosen negative instance (Senders et al. 2018).”
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“To code the implementation strategies, the modified Effective Practice and Organisation of Care (EPOC) classification was used 22 ; descriptions of categories can be found in online supplemental appendix 6.”
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Ovary Cancer Diagnosing Empowered with Machine Learning
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“For starters, AI is not the same as traditional computer programming [10].”
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“ML, which is a field of computer science, falls into a subdivision of artificial intelligence (AI) that enables algorithms to learn patterns in large, complex datasets without being explicitly programmed [19], [20].”
BackgroundMethodInfluentialMachine Learning Demonstrates High Accuracy for Disease Diagnosis and Prognosis in Plastic Surgery
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“Recently, machine learning (ML) has emerged as a powerful tool to develop predictive algorithms from a large amount of data [35].”
Background
- Authors
- Senders, J. T., Staples, P. C., Karhade, A. V., Zaki, M. M., Gormley, W. B., Broekman, M. L. D., Smith, T. R., & Arnaout, O.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- Corresponding author
- Arnaout, Omar
- ORCID
- Venue
- World Neurosurgery
- Publisher
- Elsevier BV
- Published
- 2018-01
- Volume
- 109
- Pages
- 476-486.e1
- ISSN
- 1878-8750 (ISSN-L)
- OpenAlex
- W2761529114
- Cited by
- 486
- References
- 47
- Citations by year
- 2026: 49 · 2025: 51 · 2024: 63 · 2023: 68 · 2022: 85 · 2021: 67 · 2020: 58 · 2019: 31 · 2018: 13 · 2017: 1
- FWCI
- 4.10
- Type
- journal article
- Language
- en
- Open access
- Locations
- World Neurosurgery (publishedVersion)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Topics
- Physical Sciences › Computer Science › Artificial Intelligence › Machine Learning in Healthcare
- Health Sciences › Health Professions › Health Information Management › Artificial Intelligence in Healthcare
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Keywords
- machine learning, surgical decision-making, epilepsy surgery, brain tumor surgery, spinal lesions, neurovascular disease, movement disorders, traumatic brain injury, hydrocephalus, survival prediction, recurrence prediction, adverse events, prognostic score, clinical decision support
- MeSH terms
- Machine Learning, Computer Simulation, Decision Support Techniques, Humans, Nervous System Diseases, Prognosis, Outcome Assessment, Health Care, Neurosurgical Procedures
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