عنوان انگلیسی مقاله:
Deep Learning Preoperatively Predicts Value Metrics for Primary Total Knee Arthroplasty: Development and Validation of an Artificial Neural Network Model
ترجمه فارسی عنوان مقاله:
معیار ارزش پیش بینی یادگیری عمیق قبل از عمل برای اولیه آرتروپلاستی کامل زانو: توسعه و اعتبار مدل شبکه عصبی مصنوعی
Sciencedirect - Elsevier - The Journal of Arthroplasty, 34 (2019) 2220-2228: doi:10:1016/j:arth:2019:05:034
Prem N. Ramkumar, MD, MBA a, *, Jaret M. Karnuta, MS a, Sergio M. Navarro, MBA b, Heather S. Haeberle, BS c, Giles R. Scuderi, MD d, Michael A. Mont, MD d, Viktor E. Krebs, MD a, Brendan M. Patterson, MD, MBA
Background: The objective is to develop and validate an artificial neural network (ANN) that learns and
predicts length of stay (LOS), inpatient charges, and discharge disposition before primary total knee
arthroplasty (TKA). The secondary objective applied the ANN to propose a risk-based, patient-specific
payment model (PSPM) commensurate with case complexity.
Methods: Using data from 175,042 primary TKAs from the National Inpatient Sample and an institutional
database, an ANN was developed to predict LOS, charges, and disposition using 15 preoperative variables.
Outcome metrics included accuracy and area under the curve for a receiver operating characteristic
curve. Model uncertainty was stratified by All Patient Refined comorbidity indices in establishing a riskbased
Results: The dynamic model demonstrated “learning” in the first 30 training rounds with areas under the
curve of 74.8%, 82.8%, and 76.1% for LOS, charges, and discharge disposition, respectively. The PSPM
demonstrated that as patient comorbidity increased, risk increased by 2.0%, 21.8%, and 82.6% for moderate,
major, and severe comorbidities, respectively.
Conclusion: Our deep learning model demonstrated “learning” with acceptable validity, reliability, and
responsiveness in predicting value metrics, offering the ability to preoperatively plan for TKA episodes of
care. This model may be applied to a PSPM proposing tiered reimbursements reflecting case complexity.
Keywords: machine learning | total knee arthroplasty (TKA) | artificial neural network | deep learning | artificial intelligence