Evidence map›Paper›PMID 31558311›Full record

ArticleBritish journal of anaesthesia2019

Deep-learning model for predicting 30-day postoperative mortality.

Bradley A Fritz, Zhicheng Cui, Muhan Zhang, Yujie He, Yixin Chen, Alex Kronzer, Arbi Ben Abdallah, Christopher R King, Michael S Avidan

Abstract read
In one paragraph

Article in British journal of anaesthesia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

56 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Trial
  8. Review
  9. Article
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Bradley A FritzDepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, USA. Electronic address: bafritz@wustl.edu.
Zhicheng CuiDepartment of Computer Science and Engineering, Washington University in St Louis, St Louis, MO, USA.
Muhan ZhangDepartment of Computer Science and Engineering, Washington University in St Louis, St Louis, MO, USA.
Yujie HeDepartment of Computer Science and Engineering, Washington University in St Louis, St Louis, MO, USA.
Yixin ChenDepartment of Computer Science and Engineering, Washington University in St Louis, St Louis, MO, USA.
Alex KronzerDepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, USA.
Arbi Ben AbdallahDepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, USA.
Christopher R KingDepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, USA.
Michael S AvidanDepartment of Anesthesiology, Washington University in St Louis, St Louis, MO, USA.

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
TRAINING PROGRAM IN ANESTHESIOLOGY RESEARCHT32GM108539 · NIGMS · WASHINGTON UNIVERSITY · PI Aaron J Norris · 2014 to 2026
$4.9M
TECTONICS (Telemedicine Control Tower for the OR: Navigating Information, Care and Safety) trialR01NR017916 · NINR · WASHINGTON UNIVERSITY · PI AVIDAN, MICHAEL SIMON · 2019 to 2023
$3.1M
Anesthesiology Control Tower: Feedback Alerts to Supplement Treatment (ACTFAST)R21HS024581 · AHRQ · WASHINGTON UNIVERSITY · PI AVIDAN, MICHAEL SIMON · 2017 to 2018
$300k
AHRQ HHS R21 HS024581NCATS NIH HHS UL1 TR002345NIGMS NIH HHS T32 GM108539NINR NIH HHS R01 NR017916
6 · The paper itself

Abstract

backgroundPostoperative mortality occurs in 1-2% of patients undergoing major inpatient surgery. The currently available prediction tools using summaries of intraoperative data are limited by their inability to reflect shifting risk associated with intraoperative physiological perturbations. We sought to compare similar benchmarks to a deep-learning algorithm predicting postoperative 30-day mortality.

methodsWe constructed a multipath convolutional neural network model using patient characteristics, co-morbid conditions, preoperative laboratory values, and intraoperative numerical data from patients undergoing surgery with tracheal intubation at a single medical centre. Data for 60 min prior to a randomly selected time point were utilised. Model performance was compared with a deep neural network, a random forest, a support vector machine, and a logistic regression using predetermined summary statistics of intraoperative data.

resultsOf 95 907 patients, 941 (1%) died within 30 days. The multipath convolutional neural network predicted postoperative 30-day mortality with an area under the receiver operating characteristic curve of 0.867 (95% confidence interval [CI]: 0.835-0.899). This was higher than that for the deep neural network (0.825; 95% CI: 0.790-0.860), random forest (0.848; 95% CI: 0.815-0.882), support vector machine (0.836; 95% CI: 0.802-870), and logistic regression (0.837; 95% CI: 0.803-0.871).

conclusionsA deep-learning time-series model improves prediction compared with models with simple summaries of intraoperative data. We have created a model that can be used in real time to detect dynamic changes in a patient's risk for postoperative mortality.

Indexed as

Deep LearningAlgorithmsComorbidityHumansMissouriNeural Networks, ComputerPostoperative ComplicationsPostoperative PeriodPredictive Value of TestsRetrospective StudiesRisk AssessmentSupport Vector MachineSurgical Procedures, Operativeanaesthesiologydeep learningmachine learningpostoperative complicationsrisk predictionsurgery

Identifiers

PMID31558311
PMCPMC6993109

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.