Neural networks as a prognostic tool of surgical risk in lung resections.

BACKGROUND Assessment of surgical risk in patients undergoing pulmonary resection is a fundamental goal for thoracic surgeons. Usually used risk indices do not predict the individual outcome. Neural networks (NN) are artificial intelligence software models that have been used for estimation of several prognostic situations. METHODS Ninety-six clinical and laboratory features from each one of 141 patients who underwent lung resection were retrospectively collected. The variables were used as input data for the software. Cases were divided into a training set (n = 113) and a test set (n = 28). Four NN models were trained using the data from the training set: (1) using all variables; (2) using only the Goldman and Torrington scores; (3) using all variables except for the two scores. A fourth NN was programmed with all variables to estimate the development of major postoperative complications. The trained NN models were tested with the test set data. RESULTS The NN using all variables with or without the scores were able to correctly classify all 28 test cases against actual outcome. The NN using all variables also estimated major postoperative complications correctly in all 28 test cases. The NN using only two indices (Goldman and Torrington) yielded 6 of 28 errors in classification. CONCLUSIONS These data suggest that NN can integrate results from multiple data predicting the individual outcome for patients, rather than assigning them to less-precise risk group categories.

[1]  Andrew Kusiak,et al.  Autonomous decision-making: a data mining approach , 2000, IEEE Transactions on Information Technology in Biomedicine.

[2]  L Goldman,et al.  Multifactorial index of cardiac risk in noncardiac surgical procedures. , 1977, The New England journal of medicine.

[3]  J. M. Fletcher,et al.  Linear Discriminant Function analysis in Neuropsychological Research: Some Uses and abuses , 1978, Cortex.

[4]  B Angus,et al.  The detection of nodal metastasis in breast cancer using neural network techniques , 1996, Physiological measurement.

[5]  R. Dybowski,et al.  Artificial neural networks in pathology and medical laboratories , 1995, The Lancet.

[6]  D L Rosenthal,et al.  Computer-assisted rescreening of clinically important false negative cervical smears using the PAPNET Testing System. , 1996, Acta cytologica.

[7]  R. W. Dobbins,et al.  Computational intelligence PC tools , 1996 .

[8]  L. Mango Computer-assisted cervical cancer screening using neural networks. , 1994, Cancer Letters.

[9]  R. Vollmer Multivariate statistical analysis for pathologist. Part I, The logistic model. , 1996, American journal of clinical pathology.

[10]  K. Torrington,et al.  Perioperative respiratory therapy (PORT). A program of preoperative risk assessment and individualized postoperative care. , 1988, Chest.

[11]  A. Marchevsky,et al.  The application of image analysis and neural network technology to the study of large‐cell liver‐cell dysplasia and hepatocellular carcinoma , 1997, Hepatology.

[12]  A. Marchevsky,et al.  Estimation of tumor stage and lymph node status in patients with colorectal adenocarcinoma using probabilistic neural networks and logistic regression. , 1999, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[13]  A M Marchevsky,et al.  Neural networks as a prognostic tool for patients with non-small cell carcinoma of the lung. , 1997, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[14]  R. Naguib,et al.  Artificial Neural Networks in Cancer Diagnosis, Prognosis, and Patient Management , 2000 .

[15]  Mark A. Stephenson,et al.  Artificial neural networks and logistic regression as tools for prediction of survival in patients with Stages I and II non-small cell lung cancer. , 1998, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[16]  A M Marchevsky,et al.  Image analysis and diagnostic classification of hepatocellular carcinoma using neural networks and multivariate discriminant functions. , 1994, Laboratory investigation; a journal of technical methods and pathology.

[17]  A M Marchevsky,et al.  Reasoning with uncertainty in pathology: artificial neural networks and logistic regression as tools for prediction of lymph node status in breast cancer patients. , 1999, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[18]  Patrick van der Smagt,et al.  Introduction to neural networks , 1995, The Lancet.

[19]  Neural networks as an aid in the diagnosis of lymphocyte-rich effusions. , 1995, Analytical and quantitative cytology and histology.

[20]  P. Wilding,et al.  The application of backpropagation neural networks to problems in pathology and laboratory medicine. , 1992, Archives of pathology & laboratory medicine.