Machine Learning-Based Approach to Predict Last-Minute Cancellation of Pediatric Day Surgeries.

Journal: Computers, informatics, nursing : CIN
PMID:

Abstract

The last-minute cancellation of surgeries profoundly affects patients and their families. This research aimed to forecast these cancellations using EMR data and meteorological conditions at the time of the appointment, using a machine learning approach. We retrospectively gathered medical data from 13 440 pediatric patients slated for surgery from 2018 to 2021. Following data preprocessing, we utilized random forests, logistic regression, linear support vector machines, gradient boosting trees, and extreme gradient boosting trees to predict these abrupt cancellations. The efficacy of these models was assessed through performance metrics. The analysis revealed that key factors influencing last-minute cancellations included the impact of the coronavirus disease 2019 pandemic, average wind speed, average rainfall, preanesthetic assessments, and patient age. The extreme gradient boosting algorithm outperformed other models in predicting cancellations, boasting an area under the curve value of 0.923 and an accuracy of 0.841. This algorithm yielded superior sensitivity (0.840), precision (0.837), and F1 score (0.838) relative to the other models. These insights underscore the potential of machine learning, informed by EMRs and meteorological data, in forecasting last-minute surgical cancellations. The extreme gradient boosting algorithm holds promise for clinical deployment to curtail healthcare expenses and avert adverse patient-family experiences.

Authors

  • Canping Li
    Author Affiliations: Departments of Day Surgery (Mrs C. Mr Li, Dr Huang, Mrs Chen, Mrs Zhang), Medical Information Center (Mr Z. Li), and Nursing (Mrs Zhu), Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Zheming Li
    Department of IT Center, the Children's Hospital, Zhejiang University School of Medicine, China; National Clinical Research Center for Child Health, China. Electronic address: 6513103@zju.edu.cn.
  • Shoujiang Huang
  • Xiyan Chen
  • Tingting Zhang
    Department of Environmental Science and Engineering, College of Chemical Engineering, Beijing University of Chemical Technology, Beijing 100029, China. Electronic address: zhangtt@mail.buct.edu.cn.
  • Jihua Zhu
    The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.