ArticleBMC surgery2025
Development and validation of an interpretable shap-based machine learning model for predicting postoperative complications in laryngeal cancer.
Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Machine learning-based prediction of Clavien-Dindo ≥ II complications after ureteroscopy.International urology and nephrology · 2026Article
- Development and Internal Validation of an Explainable Machine Learning Model for Predicting Buttock Claudication After EVAR: A Dual-Center Cohort Study.Bioengineering (Basel, Switzerland) · 2026Article
- Malnutrition predicts severe complications but not survival in laryngeal cancer surgery: a propensity-matched analysis.Frontiers in nutrition · 2026Article
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10 authors.
Funding
Abstract
objectivePostoperative complications remain a major concern in laryngeal cancer surgery, often requiring invasive interventions or intensive care. This study aimed to develop and validate an interpretable machine learning (ML) model to preoperatively predict Clavien-Dindo Grade ≥ III complications and support risk-informed perioperative decision-making.
methodsWe conducted a retrospective study using a temporally split cohort of laryngeal cancer patients. Postoperative complications were graded using the Clavien-Dindo (CD) classification. Eight ML algorithms were trained and evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Model interpretability was assessed using SHapley Additive exPlanations (SHAP). A web-based calculator was deployed for clinical use.
resultThe random forest (RF) model achieved the best performance, with an area under the curve (AUC) of 0.935 in the training set and 0.842 in the test set. The model demonstrated robust sensitivity and specificity for both surgical and medical complications. Calibration curves indicated strong agreement between predicted and actual outcomes. SHAP analysis identified eight key predictors-such as vocal cord mobility, tumor subsite, and nutritional status-that contributed most to risk estimation. A user-friendly web calculator was developed and is accessible at: https://qilushiny.shinyapps.io/qilupredicate/ .
conclusionWe developed a clinically interpretable ML model that accurately predicts major postoperative complications in patients undergoing laryngeal cancer surgery. This tool provides individualized risk assessments that can guide surgical planning, optimize perioperative strategies, and enhance shared decision-making. Prospective multicenter validation is needed to confirm its utility in routine practice.
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