학술논문

Development and internal validation of machine learning algorithms to predict patient satisfaction after total hip arthroplasty
Document Type
article
Source
Arthroplasty, Vol 3, Iss 1, Pp 1-8 (2021)
Subject
Machine learning
Artificial intelligence
Total hip arthroplasty
Satisfaction
Patient-reported outcome measures
Orthopedic surgery
RD701-811
Language
English
ISSN
2524-7948
Abstract
Abstract Background Patient satisfaction is a unique and important measure of success after total hip arthroplasty (THA). Our study aimed to evaluate the use of machine learning (ML) algorithms to predict patient satisfaction after THA. Methods Prospectively collected data of 1508 primary THAs performed between 2006 and 2018 were extracted from our joint replacement registry and split into training (80%) and test (20%) sets. Supervised ML algorithms (Random Forest, Extreme Gradient Boosting, Support Vector Machines, Logistic LASSO) were developed with the training set, using patient demographics, comorbidities and preoperative patient reported outcome measures (PROMs) (Short Form-36 [SF-36], physical component summary [PCS] and mental component summary [MCS], Western Ontario and McMaster’s Universities Osteoarthritis Index [WOMAC] and Oxford Hip Score [OHS]) to predict patient satisfaction at 2 years postoperatively. Predictive performance was evaluated using the independent test set. Results Preoperative models demonstrated fair discriminative ability in predicting patient satisfaction, with the LASSO model achieving a maximum AUC of 0.76. Permutation importance revealed that the most important predictors of dissatisfaction were (1) patient’s age, (2) preoperative WOMAC, (3) number of comorbidities, (4) preoperative MCS, (5) previous lumbar spine surgery, and (6) low BMI (