Rao Karthik Nagaraja, Arora Ripudaman, Rajguru Renu, Nagarkar Nitin M
Principal Consultant, Head and Neck Oncology, Sri Shankara Cancer Hospital and Research Center, Bangalore, India.
Department of Otolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Raipur, India.
Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3094-3102. doi: 10.1007/s12070-024-04608-9. Epub 2024 Mar 25.
The primary objective of this study was to use artificial neural network (ANN) to predict the post operative hypocalcemia and severity of hypocalcemia following total thyroidectomy. The secondary objective was to determine the weightage for the factors predicting the hypocalcemia with the ANN. A single center, retrospective case series included treatment-naive patients undergoing total thyroidectomy for benign or malignant thyroid nodules from January 2020 to December 2022. Artificial neural network (ANN) - Multilayer Perceptron (MLP) used to predict post-operative hypocalcemia in ANN. Multivariate analysis was used construct validity. The data of 196 total thyroidectomy cases was used for training and testing. The mean incorrect prediction during training and testing was 3.18% (± σ = 0.65%) and 3.66% (± σ = 1.88%) for hypocalcemia. The cumulative Root-Mean-Square-Error (RMSE) for MLP model was 0.29 (± σ = 0.02) and 0.32 (± σ = 0.04) for training and testing, respectively. Area under ROC was 0.98 for predicting hypocalcemia 0.942 for predicting the severity of hypocalcemia. Multivariate analysis showed lower levels of post operative parathormone levels to be predictor of hypocalcemia ( < 0.01). The maximum weightage given to iPTH (100%) > Need for sternotomy (28.55%). Our MLP NN model predicted the post-operative hypocalcemia in 96.8% of training samples and 96.3% of testing samples, and severity in 92.8% of testing sample in 10 generations. however, it must be used with caution and always in conjunction with the expertise of the surgical team. Level of Evidence - 3b.
The online version contains supplementary material available at 10.1007/s12070-024-04608-9.
本研究的主要目的是使用人工神经网络(ANN)预测全甲状腺切除术后的低钙血症及低钙血症的严重程度。次要目的是通过人工神经网络确定预测低钙血症的因素的权重。一项单中心回顾性病例系列研究纳入了2020年1月至2022年12月因良性或恶性甲状腺结节接受初次全甲状腺切除术的患者。人工神经网络(ANN)-多层感知器(MLP)用于预测人工神经网络中的术后低钙血症。采用多变量分析构建效度。196例全甲状腺切除病例的数据用于训练和测试。训练和测试期间低钙血症的平均错误预测率分别为3.18%(±标准差=0.65%)和3.66%(±标准差=1.88%)。MLP模型训练和测试的累积均方根误差(RMSE)分别为0.29(±标准差=0.02)和0.32(±标准差=0.04)。预测低钙血症的ROC曲线下面积为0.98,预测低钙血症严重程度的为0.942。多变量分析显示术后甲状旁腺激素水平较低是低钙血症的预测指标(<0.01)。给予iPTH的权重最大(100%)>胸骨切开术需求(28.55%)。我们的MLP神经网络模型在10代中预测了96.8%的训练样本和96.3%的测试样本的术后低钙血症,以及92.8%的测试样本的严重程度。然而,必须谨慎使用,并且始终要结合手术团队的专业知识。证据级别-3b。
在线版本包含可在10.1007/s12070-024-04608-9获取的补充材料。