■本研究旨在构建基于机器学习算法的预测模型,以评估结直肠癌患者术后住院时间延长的风险,并分析与住院时间延长相关的术前和术后因素。
■我们前瞻性收集了83例结直肠癌患者的临床数据。该研究包括40个变量(包括39个预测变量和1个目标变量)。重要变量通过Lasso回归算法选择变量来识别,并使用十种机器学习模型构建预测模型,包括Logistic回归,决策树,随机森林,支持向量机,轻型梯度增压机,KNN,和极端梯度提升,分类提升,人工神经网络与深层森林.使用BootstrapROC曲线和校准曲线评估模型性能,选择最优模型,并使用SHAP可解释性算法进一步解释。
■通过Lasso回归确定了十个显著相关的重要变量,由1000个Bootstrap重采样验证,并通过BootstrapROC曲线表示。Logistic回归模型获得最高的AUC(AUC=0.99,95%CI=0.97-0.99)。可解释的机器学习算法显示,手术后第三天行走的距离是LR模型最重要的变量。
■本研究利用患者临床数据成功构建了预测术后住院时间的模型。该模型有望在临床实践中为医疗保健专业人员提供更精确的预测工具,为个性化护理干预提供基础,改善患者预后和生活质量,提高医疗资源利用效率。
UNASSIGNED: This study aims to construct a predictive model based on machine learning algorithms to assess the risk of prolonged hospital stays post-surgery for colorectal cancer patients and to analyze preoperative and postoperative factors associated with extended hospitalization.
UNASSIGNED: We prospectively collected clinical data from 83 colorectal cancer patients. The study included 40 variables (comprising 39 predictor variables and 1 target variable). Important variables were identified through variable selection via the Lasso regression algorithm, and predictive models were constructed using ten machine learning models, including Logistic Regression, Decision Tree, Random Forest, Support Vector Machine, Light Gradient Boosting Machine, KNN, and Extreme Gradient Boosting, Categorical Boosting, Artificial Neural Network and Deep Forest. The model performance was evaluated using Bootstrap ROC curves and calibration curves, with the optimal model selected and further interpreted using the SHAP explainability algorithm.
UNASSIGNED: Ten significantly correlated important variables were identified through Lasso regression, validated by 1000 Bootstrap resamplings, and represented through Bootstrap ROC curves. The Logistic Regression model achieved the highest AUC (AUC=0.99, 95% CI=0.97-0.99). The explainable machine learning algorithm revealed that the distance walked on the third day post-surgery was the most important variable for the LR model.
UNASSIGNED: This study successfully constructed a model predicting postoperative hospital stay duration using patients\' clinical data. This model promises to provide healthcare professionals with a more precise prediction tool in clinical practice, offering a basis for personalized nursing interventions, thereby improving patient prognosis and quality of life and enhancing the efficiency of medical resource utilization.