Cited by 486Machine Learning in HealthcareArtificial Intelligence in HealthcareArtificial Intelligence in Healthcare and Education

Machine learning and neurosurgical outcome prediction: a systematic review

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Senders, Joeky T., Staples, Patrick C., Karhade, Aditya V., Zaki, Mark M., Gormley, William B., Broekman, Marike L.D., Smith, Timothy R., Arnaout, Omar·2018·World Neurosurgery

Abstract

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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Crossref · 10.1016/j.wneu.2017.09.149

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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).”

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  1. Breiman L. StatisticalModeling: the two cultures. Stat Sci. 2001;16:199-231.

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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
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
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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