Abstract：
BACKGROUND:Artificial intelligence is touted as the future of medicine. Classical algorithms for the detection of common bile duct stones (CBD) have had poor clinical uptake due to low accuracy. This study explores the challenges of developing and implementing a machine-learning model for the prediction of CBD stones in patients presenting with acute biliary disease (ABD). METHODS:All patients presenting acutely to Christchurch Hospital over a two-year period with ABD were retrospectively identified. Clinical data points including lab test results, demographics and ethnicity were recorded. Several statistical techniques were utilised to develop a machine-learning model. Issues with data collection, quality, interpretation and barriers to implementation were identified and highlighted. RESULTS:Issues with patient identification, coding accuracy, and implementation were encountered. In total, 1315 patients met inclusion criteria. Incorrect international classification of disease 10 (ICD-10) coding was noted in 36% (137/382) of patients recorded as having CBD stones. Patients with CBD stones were significantly older and had higher aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin and gamma-glutamyl transferase (GGT) levels (p < 0.001). The no information rate was 81% (1070/1315 patients). The optimum model developed was the gradient boosted model with a PPV of 67%, NPV of 87%, sensitivity of 37% and a specificity of 96% for common bile duct stones. CONCLUSION:This paper highlights the utility of machine learning in predicting CBD stones. Accuracy is limited by current data and issues do exist around both the ethics and practicality of implementation. Regardless, machine learning represents a promising new paradigm for surgical practice.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Tranter-Entwistle I,Wang H,Daly K,Maxwell S,Connor Sdoi
10.1007/s00268-020-05820-8subject
Has Abstractpub_date
2021-02-01 00:00:00pages
420-428issue
2eissn
0364-2313issn
1432-2323pii
10.1007/s00268-020-05820-8journal_volume
45pub_type
杂志文章abstract：BACKGROUND:Duct-to-mucosa pancreatojejunostomy after pancreatoduodenectomy can be technically difficult, particularly in cases with a non-dilated pancreatic duct. We devised a novel procedure employing a pancreatic duct holder and mucosa squeeze-out technique facilitating duct-to-mucosa anastomosis. We compared the per...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3659-y
更新日期：2016-12-01 00:00:00
abstract：:With the recent regulations limiting resident work hours, it has become more important to understand how residents spend their time. The volume and content of the pages they receive provide a valuable source of information that give insight into their workload and help identify inefficiencies in hospital communication...
journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2010-11-01 00:00:00
abstract：BACKGROUND:Postoperative ascites is a common complication after liver resection. This study aimed to identify the risk factors for ascites in patients after liver resection and the relationship between postoperative ascites and other complications. METHODS:We retrospectively analyzed data that were obtained from 266 p...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4003-x
更新日期：2017-08-01 00:00:00
abstract：:In a prospective multicenter study, 186 patients with squamous cell esophageal carcinoma, who after evaluation were considered suitable for surgery, were randomized to 4 treatment groups: Group 1, surgery alone; Group 2, pre-operative chemotherapy (cisplatin and bleomycin) and surgery; Group 3, pre-operative irradiati...
journal_title：World journal of surgery
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
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abstract：BACKGROUND:The implementation of programs to improve patient safety remains challenging in low- and middle-income countries. The goal of our study was to define the barriers and facilitators to implementation of a perioperative patient safety program in Guatemala. MATERIAL AND METHODS:We conducted semi-structured inte...
journal_title：World journal of surgery
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abstract：INTRODUCTION:Jejunal diverticula are rare lesions, and when complications arise, they pose diagnostic difficulties. Perforation is a common complication resulting in an acute abdomen, although preoperative diagnosis is usually not possible. The "gold standard" for management for patients with complications is surgery. ...
journal_title：World journal of surgery
pub_type： 杂志文章
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abstract：BACKGROUND:Frequent use of computed tomography (CT) in trauma patients results in frequent detection of non-trauma-related incidental findings (IFs). Inpatient documentation and disclosure at discharge are infrequent, even when they are potentially serious. We aimed to not only identify the incidence of IFs but also to...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2092-8
更新日期：2013-09-01 00:00:00
abstract：:Most people would agree that successful parathyroidectomy depends on two important variables: the surgeon's recognition and excision of the abnormal parathyroid gland(s) and the pathologist's confirmation that the removed tissue is parathyroid tissue. Frozen section is usually employed to confirm the identity of parat...
journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2000-11-01 00:00:00
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journal_title：World journal of surgery
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更新日期：2018-06-01 00:00:00
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journal_title：World journal of surgery
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doi：10.1007/s00268-018-4510-4
更新日期：2018-08-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF02104457
更新日期：1992-05-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689910095
更新日期：2000-05-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-001-0110-8
更新日期：2001-10-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF02067365
更新日期：1992-07-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3504-3
更新日期：2016-08-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,评审
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更新日期：2000-10-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0842-4
更新日期：2011-02-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF02104436
更新日期：1992-05-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1007/s00268-015-3050-4
更新日期：2015-08-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
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更新日期：2010-08-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2020-09-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-011-1345-7
更新日期：2012-06-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2013-05-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-002-6630-z
更新日期：2002-08-01 00:00:00
abstract：:Large ventral hernias are a significant surgical challenge. "Loss of domain" (LOD) expresses the relationship between hernia and abdominal volume, and is used to predict operative difficulty and success. This systematic review assessed whether different definitions of LOD are used in the literature. The PubMed databas...
journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2019-02-01 00:00:00
abstract：:This prospective study addresses the rate of male genital dysfunction following total mesorectal excision (TME) for rectal carcinoma using the anterior extramesorectal plane and its correlation with early urinary function, pelvic autonomic nerve preservation (PANP), and intraoperative neurostimulation (INS). A consecu...
journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2007-06-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：1993-01-01 00:00:00
abstract：BACKGROUND:Nipple-sparing mastectomy (NSM) has gained widespread popularity in recent years. Nonetheless, patient selection, technical consideration and oncological safety of its extension to breast cancer treatment remain uncertain. Few publications have reviewed the application of NSM in Asian populations. METHODS:W...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4197-y
更新日期：2018-05-01 00:00:00
