Yang Shih-Ying, Hsu Shih-Yen, Su Yi-Kai, Lu Nan-Han, Liu Kuo-Ying, Chen Tai-Been, Chiu Kon-Ning, Huang Yung-Hui, Yeh Li-Ren
Department of Anesthesiology, Taoyuan Armed Forces General Hospital, Taoyuan City 30054, Taiwan.
Department of Medical Imaging and Radiological Science, I-Shou University, Kaohsiung City 82445, Taiwan.
Diagnostics (Basel). 2024 Nov 2;14(21):2456. doi: 10.3390/diagnostics14212456.
Spinal conditions, such as fractures and herniated intervertebral discs (HIVDs), are often challenging to diagnose due to overlapping clinical symptoms and the difficulty in assessing their functional impact. Accurate differentiation between these conditions is crucial for effective treatment, particularly in the context of preoperative anesthesia evaluation, where understanding the underlying condition can influence anesthesia planning and pain management. This study presents a Support Vector Machine (SVM) model designed to distinguish between spinal fractures and HIVDs using key clinical predictors, including age, gender, preoperative Visual Analog Scale (VAS) pain scores, and the number of spinal fractures. A retrospective analysis was conducted on a dataset of 199 patients diagnosed with these conditions. The SVM model, using a radial basis function (RBF) kernel, classified the conditions based on the selected predictors. Model performance was evaluated using precision, recall, accuracy, and the Kappa index, with Leave-One-Out (LOO) cross-validation applied to ensure robust results. The SVM model achieved a precision of 92.1% for fracture cases and 91.2% for HIVDs, with recall rates of 98.1% for fractures and 70.5% for HIVDs. The overall accuracy was 92%, and the Kappa index was 0.76, indicating substantial agreement. The analysis revealed that age and VAS pain scores were the most critical predictors for accurately diagnosing these conditions. These results highlight the potential of the SVM model with an RBF kernel to reliably differentiate between spinal fractures and HIVDs using routine clinical data. Future work could enhance model performance by incorporating additional clinical parameters relevant to preoperative anesthesia evaluation.
脊柱疾病,如骨折和椎间盘突出症(HIVD),由于临床症状重叠以及评估其功能影响存在困难,往往难以诊断。准确区分这些疾病对于有效治疗至关重要,特别是在术前麻醉评估的背景下,了解潜在病情会影响麻醉计划和疼痛管理。本研究提出了一种支持向量机(SVM)模型,旨在使用关键临床预测指标(包括年龄、性别、术前视觉模拟量表(VAS)疼痛评分和脊柱骨折数量)来区分脊柱骨折和HIVD。对199例诊断为这些疾病的患者数据集进行了回顾性分析。使用径向基函数(RBF)核的SVM模型根据选定的预测指标对疾病进行分类。使用精确率、召回率、准确率和Kappa指数评估模型性能,并应用留一法(LOO)交叉验证以确保结果稳健。SVM模型对骨折病例的精确率为92.1%,对HIVD的精确率为91.2%,骨折的召回率为98.1%,HIVD的召回率为70.5%。总体准确率为92%,Kappa指数为0.76,表明一致性较高。分析表明,年龄和VAS疼痛评分是准确诊断这些疾病的最关键预测指标。这些结果突出了具有RBF核的SVM模型利用常规临床数据可靠区分脊柱骨折和HIVD的潜力。未来的工作可以通过纳入与术前麻醉评估相关的其他临床参数来提高模型性能。