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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 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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“A previous review showed that machine learning models displayed excellent performance in predicting the outcomes of various neurosurgical conditions, outstripping established prognostic indicators and clinical experts [8].”
BackgroundMenna, G., Caccavella, V. M., Olivi, A., & Pepa, G. M. D. (2021) · Neurosurgery · doi:10.1093/neuros/nyab045 · Cited by 1
A New Feature Selection Method Based on Class Association Rule
Al-Dhaheri, S. A. (2021) · CUNY Academic Works (City University of New York) · Cited by 1
Machine Learning in Vascular Surgery: A Systematic Review and Critical AppraisalPreprint
Li, B., Feridooni, T., Cuen-Ojeda, C., Kishibe, T., de Mestral, C., Mamdani, M., & Al-Omran, M. (2021) · SSRN Electronic Journal · doi:10.2139/ssrn.3867678 · Cited by 1
Machine Learning: An Aid in Detection of Neurodegenerative Disease Parkinson
Sisodia, J., & Kalbande, D. R. (2020) · Lecture notes on data engineering and communications technologies · doi:10.1007/978-3-030-38040-3_84
Artificial intelligence for management of patients with intracranial neoplasms
Mammi, M., Boaro, A., Kavouridis, V. K., Hulsbergen, A. F. C., Senders, J. T., Gormley, W. B., Smith, T. R., & Arnaout, O. M. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-817133-2.00009-4
Self-citationPredictive Analysis in Chiari Malformation Type I
Thakar, S., Aryan, S., Mani, S., & Sarma, R. R. (2020) · Springer eBooks · doi:10.1007/978-3-030-44862-2_48
Analysis of anesthesia-related prognostic indicators in neurosurgery
Zhang, Z., Wang, Q., Zhou, F., & Liu, Y. (2020) · Asian Journal of Surgery · doi:10.1016/j.asjsur.2020.05.034
Predicting Complications After Spinal Surgery: Surgeons’ Aided and Unaided Predictions
Kingwell, S. P. (2020) · uO Research (University of Ottawa) · doi:10.20381/ruor-25781
Chronic subdural hematoma - diagnosis, treatment and perspectives
Juković, M., & Till, V. (2020) · Medicinski pregled · doi:10.2298/mpns2010295j
“Today, machine learning techniques, based on computer softwares, can optimize protocols and improve patient treatment and outcome [51, 52].”
MethodCommentary: Predicting Spinal Surgery Candidacy From Imaging Data Using Machine Learning
Gooldy, T. C., & Snyder, L. A. (2021) · Neurosurgery · doi:10.1093/neuros/nyab227
“13,14 In theory, an AI system can benefit all the parties involved.”
BackgroundSenanayake, S. J. (2021) · Queensland University of Technology · doi:10.5204/thesis.eprints.211469
Artificial Intelligence and Healthcare Ethics
Rana, A., Goedmakers, C. M. W., & Smith, T. R. (2021) · Springer eBooks · doi:10.1007/978-3-030-78075-3_31
Self-citationChen, Y., Deng, X., Yang, P., Wu, S., Wang, X., Zhou, H., Chen, X., Wang, X., Wu, W., Ke, K., et al. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4016601
Das, D., & Mahanta, L. B. (2022) · Springer eBooks · doi:10.1007/978-3-030-64573-1_189
Machine learning models for predicting lymph node and distant metastases in colorectal cancerPreprint
Dai, X., Dai, S., Yang, X., Jing, Z., Liu, J., & Han, S. (2020) · Research Square · doi:10.21203/rs.3.rs-45372/v2
Analysis of anesthesia-related prognostic indicators in neurosurgeryPreprint
Shu, A., Wang, Q., Chen, X., Zhou, F., & Liu, Y. (2019) · doi:10.21203/rs.2.18970/v1
“A comprehensive, accurate and timely risk assessment that includes perioperative information would help anesthesiologists and neurosurgeons make adequate preoperative preparations, and plans for effective measures that deal with potential issues occurring during the intraoperative and perioperative periods [3].”
BackgroundAhmed, K., Pennington, Z. A., Molina, C. A., & Sciubba, D. M. (2020) · Springer eBooks · doi:10.1007/978-3-319-33037-2_127-1
EHR Data: Enabling Clinical Surveillance and Alerting
Herasevich, V., Lipatov, K., & Pickering, B. W. (2022) · Health informatics · doi:10.1007/978-3-030-91237-6_13
Studies on the treatment of bone metastases
Pielkenrood, B. J. (2022) · doi:10.33540/1391
Metadata
- 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
- 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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