Artificial Neural Network Individualised Prediction of Time to Colorectal Cancer Surgery
Aim. Colorectal cancer pathway targets mandate prompt treatment although practicalities may mean patients wait for surgery. This variable period could be utilised for patient optimisation; however, there is currently no reliable predictive system for time to surgery. If individualised surgical waits...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/1285931 |
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| author | N. J. Curtis G. Dennison E. Salib D. A. Hashimoto N. K. Francis |
| author_facet | N. J. Curtis G. Dennison E. Salib D. A. Hashimoto N. K. Francis |
| author_sort | N. J. Curtis |
| collection | DOAJ |
| description | Aim. Colorectal cancer pathway targets mandate prompt treatment although practicalities may mean patients wait for surgery. This variable period could be utilised for patient optimisation; however, there is currently no reliable predictive system for time to surgery. If individualised surgical waits were prospectively known, tailored prehabilitation could be introduced. Methods. A dedicated, prospectively populated elective laparoscopic surgery for colorectal cancer with a curative intent database was utilised. Primary endpoint was the prediction of the individualised waiting time for surgery. A multilayered perceptron artificial neural network (ANN) model was trained and tested alongside uni- and multivariate analyses. Results. 668 consecutive patients were included. 8.5% underwent neoadjuvant chemoradiotherapy. The mean time from diagnosis to surgery was 53 days (95% CI 48.3-57.8). ANN correctly identified those having surgery in <8 (97.7% and 98.8%) and <12 weeks (97.1% and 98.8%) of the training and testing cohorts with area under the receiver operating curves of 0.793 and 0.865, respectively. After neoadjuvant treatment, an ASA physical status score was the most important potentially modifiable risk factor for prolonged waits (normalised importance 64%, OR 4.9, 95% CI 1.5-16). The ANN findings were accurately cross-validated with a logistic regression model. Conclusion. Artificial neural networks using demographic and diagnostic data successfully predict individual time to colorectal cancer surgery. This could assist the personalisation of preoperative care including the incorporation of prehabilitation interventions. |
| format | Article |
| id | doaj-art-89a7b99e2c0944e6877344cd9f9fccc0 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-89a7b99e2c0944e6877344cd9f9fccc02025-08-20T03:38:02ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/12859311285931Artificial Neural Network Individualised Prediction of Time to Colorectal Cancer SurgeryN. J. Curtis0G. Dennison1E. Salib2D. A. Hashimoto3N. K. Francis4Department of Surgery and Cancer, Imperial College London, Level 10, St. Mary’s Hospital, Praed Street, London W2 1NY, UKDepartment of General Surgery, Yeovil District Hospital NHS Foundation Trust, Higher Kingston, Yeovil BA21 4AT, UKFaculty of Health and Life Sciences, University of Liverpool, Brownlow Hill, Liverpool L69 7ZX, UKDepartment of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USADepartment of General Surgery, Yeovil District Hospital NHS Foundation Trust, Higher Kingston, Yeovil BA21 4AT, UKAim. Colorectal cancer pathway targets mandate prompt treatment although practicalities may mean patients wait for surgery. This variable period could be utilised for patient optimisation; however, there is currently no reliable predictive system for time to surgery. If individualised surgical waits were prospectively known, tailored prehabilitation could be introduced. Methods. A dedicated, prospectively populated elective laparoscopic surgery for colorectal cancer with a curative intent database was utilised. Primary endpoint was the prediction of the individualised waiting time for surgery. A multilayered perceptron artificial neural network (ANN) model was trained and tested alongside uni- and multivariate analyses. Results. 668 consecutive patients were included. 8.5% underwent neoadjuvant chemoradiotherapy. The mean time from diagnosis to surgery was 53 days (95% CI 48.3-57.8). ANN correctly identified those having surgery in <8 (97.7% and 98.8%) and <12 weeks (97.1% and 98.8%) of the training and testing cohorts with area under the receiver operating curves of 0.793 and 0.865, respectively. After neoadjuvant treatment, an ASA physical status score was the most important potentially modifiable risk factor for prolonged waits (normalised importance 64%, OR 4.9, 95% CI 1.5-16). The ANN findings were accurately cross-validated with a logistic regression model. Conclusion. Artificial neural networks using demographic and diagnostic data successfully predict individual time to colorectal cancer surgery. This could assist the personalisation of preoperative care including the incorporation of prehabilitation interventions.http://dx.doi.org/10.1155/2019/1285931 |
| spellingShingle | N. J. Curtis G. Dennison E. Salib D. A. Hashimoto N. K. Francis Artificial Neural Network Individualised Prediction of Time to Colorectal Cancer Surgery Gastroenterology Research and Practice |
| title | Artificial Neural Network Individualised Prediction of Time to Colorectal Cancer Surgery |
| title_full | Artificial Neural Network Individualised Prediction of Time to Colorectal Cancer Surgery |
| title_fullStr | Artificial Neural Network Individualised Prediction of Time to Colorectal Cancer Surgery |
| title_full_unstemmed | Artificial Neural Network Individualised Prediction of Time to Colorectal Cancer Surgery |
| title_short | Artificial Neural Network Individualised Prediction of Time to Colorectal Cancer Surgery |
| title_sort | artificial neural network individualised prediction of time to colorectal cancer surgery |
| url | http://dx.doi.org/10.1155/2019/1285931 |
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