Explainable machine-learning predictions for complications after pediatric congenital heart surgery.

Journal: Scientific reports
Published Date:

Abstract

The quality of treatment and prognosis after pediatric congenital heart surgery remains unsatisfactory. A reliable prediction model for postoperative complications of congenital heart surgery patients is essential to enable prompt initiation of therapy and improve the quality of prognosis. Here, we develop an interpretable machine-learning-based model that integrates patient demographics, surgery-specific features and intraoperative blood pressure data for accurately predicting complications after pediatric congenital heart surgery. We used blood pressure variability and the k-means algorithm combined with a smoothed formulation of dynamic time wrapping to extract features from time-series data. In addition, SHAP framework was used to provide explanations of the prediction. Our model achieved the best performance both in binary and multi-label classification compared with other consensus-based risk models. In addition, this explainable model explains why a prediction was made to help improve the clinical understanding of complication risk and generate actionable knowledge in practice. The combination of model performance and interpretability is easy for clinicians to trust and provide insight into how they should respond before the condition worsens after pediatric congenital heart surgery.

Authors

  • Xian Zeng
    The College of Biomedical Engineering and Instrument Science, Zhejiang University, 310027 Hangzhou, Zhejiang, China.
  • Yaoqin Hu
    The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
  • Liqi Shu
    Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI, United States.
  • Jianhua Li
    Department of Plastic Surgery, Affiliated Hospital of Xuzhou Medical University, 99 Huai-hai West Road, 221002 Xuzhou, Jiangsu, China.
  • Huilong Duan
    The College of Biomedical Engineering and Instrument Science, Zhejiang University, 310027 Hangzhou, Zhejiang, China.
  • Qiang Shu
    Cardiac Surgery,Children's Hospital, Zhejiang University School of Medicine, 310052 Hangzhou, Zhejiang, China.
  • Haomin Li
    Clinical Data Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 310052 Hangzhou, Zhejiang, China.