Development and validation of a machine learning-based early prediction model for massive intraoperative bleeding in patients with primary hepatic malignancies

BACKGROUND Surgical resection remains the primary treatment for hepatic malignancies,and intraoperative bleeding is associated with a significantly increased risk of death.Therefore,accurate prediction of intraoperative bleeding risk in patients with hepatic malignancies is essential to preventing bleeding in advance and providing safer and more effective treatment.AIM To develop a predictive model for intraoperative bleeding in primary hepatic malignancy patients for improving surgical planning and outcomes.METHODS The retrospective analysis enrolled patients diagnosed with primary hepatic malignancies who underwent surgery at the Hepatobiliary Surgery Department of the Fourth Hospital of Hebei Medical University between 2010 and 2020.Logistic regression analysis was performed to identify potential risk factors for intraoperative bleeding.A prediction model was developed using Python programming language,and its accuracy was evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Among 406 primary liver cancer patients,16.0%(65/406)suffered massive intraoperative bleeding.Logistic regression analysis identified four variables as associated with intraoperative bleeding in these patients:ascites[odds ratio(OR):22.839;P<0.05],history of alcohol consumption(OR:2.950;P<0.015),TNM staging(OR:2.441;P<0.001),and albumin-bilirubin score(OR:2.361;P<0.001).These variables were used to construct the prediction model.The 406 patients were randomly assigned to a training set(70%)and a prediction set(30%).The area under the ROC curve values for the model’s ability to predict intraoperative bleeding were 0.844 in the training set and 0.80 in the prediction set.CONCLUSION The developed and validated model predicts significant intraoperative blood loss in primary hepatic malignancies using four preoperative clinical factors by considering four preoperative clinical factors:ascites,history of alcohol consumption,TNM staging,and albumin-bilirubin score.Consequently,this model holds promise for enhancing individualised surgical planning.

ECG quality assessment based on a kernel support vector machine and genetic algorithm with a feature matrix

We propose a systematic ECG quality classification method based on a kernel support vector machine(KSVM) and genetic algorithm(GA) to determine whether ECGs collected via mobile phone are acceptable or not. This method includes mainly three modules, i.e., lead-fall detection, feature extraction, and intelligent classification. First, lead-fall detection is executed to make the initial classification. Then the power spectrum, baseline drifts, amplitude difference, and other time-domain features for ECGs are analyzed and quantified to form the feature matrix. Finally, the feature matrix is assessed using KSVM and GA to determine the ECG quality classification results. A Gaussian radial basis function(GRBF) is employed as the kernel function of KSVM and its performance is compared with that of the Mexican hat wavelet function(MHWF). GA is used to determine the optimal parameters of the KSVM classifier and its performance is compared with that of the grid search(GS) method. The performance of the proposed method was tested on a database from PhysioNet/Computing in Cardiology Challenge 2011, which includes 1500 12-lead ECG recordings. True positive(TP), false positive(FP), and classification accuracy were used as the assessment indices. For training database set A(1000 recordings), the optimal results were obtained using the combination of lead-fall, GA, and GRBF methods, and the corresponding results were: TP 92.89%, FP 5.68%, and classification accuracy 94.00%. For test database set B(500 recordings), the optimal results were also obtained using the combination of lead-fall, GA, and GRBF methods, and the classification accuracy was 91.80%.