FAST—framework for AI-based surgical transformation
Bibliographic record
Abstract
Background: The use of machine learning (ML) in surgery till date has largely focused on predication of surgical variables, which has not been found to significantly improve operating room efficiencies and surgical success rates (SSR). Due to the long surgery wait times, limited health care resources and an increased population need, innovative ML models are needed. Thus, the Framework for AI-based Surgical Transformation (FAST) was created to make real time recommendations to improve OR efficiency. Methods: The FAST model was developed and evaluated using a dataset of n=4796 orthopedic cases that utilizes surgery and team specific variables (e.g. specific team composition, OR turnover time, procedure duration), along with regular positive deviance seminars with the stakeholders for adherence and uptake. FAST was created using six ML algorithms, including decision trees and neural networks. The FAST was implemented in orthopedic surgeries at a hospital in Canada's capital (Ottawa). Results: FAST was found to be feasible and implementable in the hospital orthopedic OR, with good team engagement due to the PD seminars. FAST led to a SSR of 93% over 23 weeks (57 arthroplasty surgery days) compared to 39% at baseline. Key variables impacting SSR included starting the first surgery on time, turnover time, and team composition. Conclusions: FAST is a novel ML framework that can provide real time feedback for improving OR efficiency and SSR. Stakeholder integration is key in its success in uptake and adherence. This unique framework can be implemented in different hospitals and for diverse surgeries, offering a novel and innovative application of ML for improving OR efficiency without additional resources.
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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 | 0.003 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.002 |
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".