Construct validation of machine learning in the prediction of short-term postoperative complications following total shoulder arthroplasty

Journal of Shoulder and Elbow Surgery
Anirudh K GowdJoseph N Liu

Abstract

We aimed to demonstrate that supervised machine learning (ML) models can better predict postoperative complications after total shoulder arthroplasty (TSA) than comorbidity indices. The American College of Surgeons-National Surgical Quality Improvement Program database was queried from 2005-2017 for TSA cases. Training and validation sets were created by randomly assigning 80% and 20% of the data set. Included variables were age, body mass index (BMI), operative time, smoking status, comorbidities, diagnosis, and preoperative hematocrit and albumin. Complications included any adverse event, transfusion, extended length of stay (>3 days), surgical site infection, return to the operating room, deep vein thrombosis or pulmonary embolism, and readmission. Each SML algorithm was compared with one another and to a baseline model using American Society of Anesthesiologists (ASA) classification. Model strength was evaluated by calculating the area under the receiver operating characteristic curve (AUC) and the positive predictive value (PPV) of complications. We identified a total of 17,119 TSA cases. Mean age, BMI, and length of stay were 69.5 ± 9.6 years, 31.1 ± 6.8, and 2.0 ± 2.2 days. Percentage hematocrit, BMI, and operative time ...Continue Reading

Citations

Jul 16, 2020·Clinical Orthopaedics and Related Research·Anders El-GalalyJonathan A Forsberg
Apr 26, 2020·Clinical Orthopaedics and Related Research·Vikas KumarAnkur Teredesai
Jan 10, 2021·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Yining LuBrian Forsythe
Sep 2, 2020·Journal of Shoulder and Elbow Surgery·Varun ArvindPaul J Cagle
Aug 22, 2020·Journal of Shoulder and Elbow Surgery·Vikas KumarAnkur Teredesai
Apr 14, 2021·The Journal of Surgical Research·Omar ElfanagelyJohn P Fischer
May 9, 2021·Journal of Shoulder and Elbow Surgery·William AibinderChristopher Roche
Aug 29, 2021·Journal of Shoulder and Elbow Surgery·Robert A BurnettGrant E Garrigues

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