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外科组学:使用多模态数据的机器学习对手术发病率、死亡率和长期结果进行个体化预测。

Surgomics: personalized prediction of morbidity, mortality and long-term outcome in surgery using machine learning on multimodal data.

机构信息

Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.

National Center for Tumor Diseases (NCT), Heidelberg, Germany.

出版信息

Surg Endosc. 2022 Nov;36(11):8568-8591. doi: 10.1007/s00464-022-09611-1. Epub 2022 Sep 28.


DOI:10.1007/s00464-022-09611-1
PMID:36171451
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9613751/
Abstract

BACKGROUND: Personalized medicine requires the integration and analysis of vast amounts of patient data to realize individualized care. With Surgomics, we aim to facilitate personalized therapy recommendations in surgery by integration of intraoperative surgical data and their analysis with machine learning methods to leverage the potential of this data in analogy to Radiomics and Genomics. METHODS: We defined Surgomics as the entirety of surgomic features that are process characteristics of a surgical procedure automatically derived from multimodal intraoperative data to quantify processes in the operating room. In a multidisciplinary team we discussed potential data sources like endoscopic videos, vital sign monitoring, medical devices and instruments and respective surgomic features. Subsequently, an online questionnaire was sent to experts from surgery and (computer) science at multiple centers for rating the features' clinical relevance and technical feasibility. RESULTS: In total, 52 surgomic features were identified and assigned to eight feature categories. Based on the expert survey (n = 66 participants) the feature category with the highest clinical relevance as rated by surgeons was "surgical skill and quality of performance" for morbidity and mortality (9.0 ± 1.3 on a numerical rating scale from 1 to 10) as well as for long-term (oncological) outcome (8.2 ± 1.8). The feature category with the highest feasibility to be automatically extracted as rated by (computer) scientists was "Instrument" (8.5 ± 1.7). Among the surgomic features ranked as most relevant in their respective category were "intraoperative adverse events", "action performed with instruments", "vital sign monitoring", and "difficulty of surgery". CONCLUSION: Surgomics is a promising concept for the analysis of intraoperative data. Surgomics may be used together with preoperative features from clinical data and Radiomics to predict postoperative morbidity, mortality and long-term outcome, as well as to provide tailored feedback for surgeons.

摘要

背景:个性化医学需要整合和分析大量的患者数据,以实现个性化护理。通过 Surgomics,我们旨在通过整合术中手术数据及其与机器学习方法的分析,利用这一数据的潜力,实现手术中的个性化治疗建议。类比于 Radiomics 和 Genomics。

方法:我们将 Surgomics 定义为从多模态术中数据中自动提取的手术过程特征的总和,以量化手术室中的过程。在一个多学科团队中,我们讨论了潜在的数据来源,如内窥镜视频、生命体征监测、医疗设备和仪器以及相应的 Surgomics 特征。随后,我们向来自多个中心的外科和(计算机)科学专家发送了在线问卷,以评估这些特征的临床相关性和技术可行性。

结果:总共确定了 52 个 Surgomics 特征,并将其分配到八个特征类别中。根据专家调查(n=66 名参与者),外科医生认为最具临床相关性的特征类别是“手术技能和手术质量”,用于发病率和死亡率(数值评分量表上的 1 到 10,评分为 9.0±1.3),以及长期(肿瘤)结果(8.2±1.8)。(计算机)科学家认为最具自动提取可行性的特征类别是“仪器”(评分为 8.5±1.7)。在各自类别中被评为最相关的 Surgomics 特征中包括“术中不良事件”、“仪器操作”、“生命体征监测”和“手术难度”。

结论:Surgomics 是分析术中数据的一个很有前途的概念。Surgomics 可以与临床数据和 Radiomics 中的术前特征一起用于预测术后发病率、死亡率和长期结果,以及为外科医生提供个性化反馈。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d5c/9613751/275631c0993e/464_2022_9611_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d5c/9613751/905513871fc7/464_2022_9611_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d5c/9613751/96d4f33c8422/464_2022_9611_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d5c/9613751/275631c0993e/464_2022_9611_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d5c/9613751/905513871fc7/464_2022_9611_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d5c/9613751/96d4f33c8422/464_2022_9611_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d5c/9613751/275631c0993e/464_2022_9611_Fig3_HTML.jpg

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[10]
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本文引用的文献

[1]
Outcome of Pancreatic Surgery During the First 6 Years of a Mandatory Audit Within the Dutch Pancreatic Cancer Group.

Ann Surg. 2023-8-1

[2]
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[4]
Radiomics for the Prediction of Response to Antifibrotic Treatment in Patients with Idiopathic Pulmonary Fibrosis: A Pilot Study.

Diagnostics (Basel). 2022-4-15

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Computed Tomography-Based Texture Features for the Risk Stratification of Portal Hypertension and Prediction of Survival in Patients With Cirrhosis: A Preliminary Study.

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Sci Rep. 2022-3-8

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Med Biol Eng Comput. 2022-4

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