{Reference Type}: Journal Article
{Title}: Comparison of Classically and Machine Learning Generated Survival Prediction Models for Patients With Spinal Metastasis - A meta-Analysis of Two Recently Developed Algorithms.
{Author}: Yen HK;Lin WH;Groot OQ;Chen CW;Yang JJ;Bongers MER;Karhade A;Shah A;Yang TC;Bindels BJ;Dai SH;Verlaan JJ;Schwab J;Yang SH;Hornicek FJ;Hu MH;
{Journal}: Global Spine J
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 28
{Factor}: 2.23
{DOI}: 10.1177/21925682231162817
{Abstract}: <B>METHODS: </B>A systemic review and a meta-analysis. We also provided a retrospective cohort for validation in this study.<BR><B>OBJECTIVE: </B>(1) Using a meta-analysis to determine the pooled discriminatory ability of The Skeletal Oncology Research Group (SORG) classical algorithm (CA) and machine learning algorithms (MLA); and (2) test the hypothesis that SORG-CA has less variability in performance than SORG-MLA in non-American validation cohorts as SORG-CA does not incorporates regional-specific variables such as body mass index as input.<BR><B>METHODS: </B>After data extraction from the included studies, logit-transformation was applied for extracted AUCs for further analysis. The discriminatory abilities of both algorithms were directly compared by their logit (AUC)s. Further subgroup analysis by region (America vs non-America) was also conducted by comparing the corresponding logit (AUC).<BR><B>RESULTS: </B>The pooled logit (AUC)s of 90-day SORG-CA was .82 (95% confidence interval [CI], .53-.11), 1-year SORG-CA was 1.11 (95% CI, .74-1.48), 90-day SORG-MLA was 1.36 (95% CI, 1.09-1.63), and 1-year SORG-MLA was 1.57 (95% CI, 1.17-1.98). All the algorithms performed better in United States than in Taiwan (P < .001). The performance of SORG-CA was less influenced by a non-American cohort than SORG-MLA.<BR><B>CONCLUSIONS: </B>These observations might highlight the importance of incorporating region-specific variables into existing models to make them generalizable to racially or geographically distinct regions.