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基于贝叶斯层次模型的手术室手术时间估计方法:适用于历史数据较少或没有历史数据的手术。

Bayesian hierarchical modeling of operating room times for surgeries with few or no historic data.

机构信息

Departamento de Calidad y Producción, Instituto Tecnológico Metropolitano, Cl 73 No. 76A - 354, Medellín, ZIP 050034, Colombia.

Facultad de Ingeniería, Institución Universitaria Pascual Bravo, Cl 73 No. 73A - 226, Medellín, ZIP 050034, Colombia.

出版信息

J Clin Monit Comput. 2022 Jun;36(3):687-702. doi: 10.1007/s10877-021-00696-y. Epub 2021 Apr 27.

DOI:10.1007/s10877-021-00696-y
PMID:33907937
Abstract

In this work it is proposed a modeling for operating room times based on a Bayesian Hierarchical structure. Specifically, it is employed a Bayesian generalized linear mixed model with an additional hierarchical level on the random effects. This configuration allows the estimation of operating room times (ORT) with few or no historical observations, without requiring a prior surgeon's estimate. In addition to the widely used lognormal distribution, it is also studied the gamma distribution to model the operating room times. For the scale parameters related to the random effects (surgeon and surgical group), which are important quantities in this type of modeling, different kinds of prior distributions such as Half-Cauchy, Sbeta2, and uniform are studied. A Bayesian version of the classical ANOVA is implemented to identify relevant predictors for the operating room times. We find that lognormal models outperform the gamma models in estimating upper prediction bounds (UB). Especially, the best ORT predictions for cases with few or no historical data (i.e., between 0 and 3 historical cases) are obtained with the [Formula: see text], SBeta2 model. With a deviation of less than 1% with respect to the nominal coverage of the upper bound predictions UB80% and UB90% and an average absolute percentage error of 38.5% in the point estimate.

摘要

在这项工作中,提出了一种基于贝叶斯层次结构的手术室时间建模方法。具体来说,采用了具有附加随机效应分层级别的贝叶斯广义线性混合模型。这种配置允许在没有历史观测或很少历史观测的情况下估计手术室时间(ORT),而无需事先估算外科医生的手术时间。除了广泛使用的对数正态分布外,还研究了伽马分布来对手术室时间进行建模。对于与随机效应(外科医生和手术组)相关的尺度参数,这是此类建模中的重要参数,研究了不同类型的先验分布,如半柯西分布、Sbeta2 分布和均匀分布。实现了贝叶斯版本的经典方差分析(ANOVA)来识别手术室时间的相关预测因子。我们发现对数正态模型在估计上预测界(UB)方面优于伽马模型。特别是,对于历史数据较少或没有历史数据的病例(即,只有 0 到 3 个历史病例),使用 [公式:见文本]、SBeta2 模型可以获得最佳的 ORT 预测。UB80%和 UB90%的上预测界的名义覆盖率偏差小于 1%,点估计的平均绝对百分比误差为 38.5%。

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本文引用的文献

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Improving Operating Room Efficiency: Machine Learning Approach to Predict Case-Time Duration.提高手术室效率:机器学习预测手术时间。
J Am Coll Surg. 2019 Oct;229(4):346-354.e3. doi: 10.1016/j.jamcollsurg.2019.05.029. Epub 2019 Jul 13.
2
Decision support system for the operating room rescheduling problem.手术室调度问题的决策支持系统。
Health Care Manag Sci. 2012 Dec;15(4):355-72. doi: 10.1007/s10729-012-9202-2. Epub 2012 Jun 13.
3
Prediction of surgery times and scheduling of operation theaters in ophthalmology department.
预测眼科手术时间和手术室安排。
J Med Syst. 2012 Apr;36(2):415-30. doi: 10.1007/s10916-010-9486-z. Epub 2010 Apr 14.
4
Influence of procedure classification on process variability and parameter uncertainty of surgical case durations.手术分类对手术持续时间过程变异性和参数不确定性的影响。
Anesth Analg. 2010 Apr 1;110(4):1155-63. doi: 10.1213/ANE.0b013e3181d3e79d.
5
Predicting the unpredictable: a new prediction model for operating room times using individual characteristics and the surgeon's estimate.预测不可预测的事情:使用个体特征和外科医生的预估来建立手术室时间的新预测模型。
Anesthesiology. 2010 Jan;112(1):41-9. doi: 10.1097/ALN.0b013e3181c294c2.
6
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7
Automatic updating of times remaining in surgical cases using bayesian analysis of historical case duration data and "instant messaging" updates from anesthesia providers.利用历史病例持续时间数据的贝叶斯分析以及麻醉提供者的“即时消息”更新,自动更新手术病例剩余时间。
Anesth Analg. 2009 Mar;108(3):929-40. doi: 10.1213/ane.0b013e3181921c37.
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Identification of systematic underestimation (bias) of case durations during case scheduling would not markedly reduce overutilized operating room time.在病例安排过程中识别病例持续时间的系统性低估(偏差)不会显著减少手术室时间的过度使用。
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