Machine learning-based models predict postoperative cardiovascular and neurological complications after pneumonectomy: A 10-year retrospective observational study
Bibliographic record
Abstract
Abstract Background Reducing postoperative cardiovascular and neurological complications (PCNC) in thoracic surgery is key for improving postoperative survival. Therefore, we aimed to investigate the independent predictors of PCNC, develop machine learning models, and construct a predictive nomogram for PCNC in patients undergoing thoracic surgery for lung cancer. Methods This study used data from a previous retrospective study of 16,368 lung cancer patients with American Standards Association physical status I-IV who underwent surgery. Postoperative information was collected from electronic medical records; the optimal model was analyzed and filtered using multiple machine learning models (Logistic regression, eXtreme Gradient Boosting, Random Forest, Light Gradient Boosting Machine, and Naïve Bayes). The predictive nomogram was built, and the efficacy, accuracy, discriminatory power, and clinical validity were assessed using receiver operator characteristics, calibration curves, and decision curve analysis. Results Multivariate logistic regression analysis showed that age, duration of surgery, intraoperative intercostal nerve block, postoperative patient-controlled analgesia, bronchial blocker, and sufentanil were independent predictors of PCNC. Random forest was identified as the optimal model with an area under the curve of 0.898 in the training set and 0.752 in the validation set, confirming the excellent prediction accuracy of the nomogram. All the net benefits of five machine learning models in the training and validation sets demonstrated excellent clinical applicability, and calibration curves also showed good agreement between the predicted and observed risks. Conclusion The combination of machine learning models and nomograms may contribute to the early prediction and reduction of the incidence of PCNC.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".