A Sneak-Peek into the Physician’s Brain: A Retrospective Machine Learning-Driven Investigation of Decision-Making in TAVR versus SAVR for Young High-Risk Patients with Severe Symptomatic Aortic Stenosis

Hašimbegović, Ena; Papp, László; Grahovac, Marko; Krajnc, Denis; Poschner, Thomas; Hasan, Waseem; Andreas, Martin; Gross, Christoph; Strouhal, Andreas; Delle‐Karth, Georg; Grabenwöger, Martin; Adlbrecht, Christopher; Mach, Markus

doi:10.3390/jpm11111062

Cited by 10 publications

(6 citation statements)

References 56 publications

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“…Of 2417 records initially identified, 82 were included in the final analysis (Figure 1) (10,16,21–100). In rare cases, research reports referred to autoML or similar terms in the broader context of ‘ML that automates’, despite not utilising autoML technology: these articles were excluded under criterion 4 (101,102).…”

Section: Resultsmentioning

confidence: 99%

Clinical performance of automated machine learning: a systematic review

Thirunavukarasu,

Elangovan,

Gutierrez

et al. 2023

Preprint

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Introduction Automated machine learning (autoML) removes technical and technological barriers to building artificial intelligence models. We aimed to summarise the clinical applications of autoML, assess the capabilities of utilised platforms, evaluate the quality of the evidence trialling autoML, and gauge the performance of autoML platforms relative to conventionally developed models, as well as each other. Methods This review adhered to a PROSPERO-registered protocol (CRD42022344427). The Cochrane Library, Embase, MEDLINE, and Scopus were searched from inception to 11 July 2022. Two researchers screened abstracts and full texts, extracted data and conducted quality assessment. Disagreement was resolved through discussion and as-required arbitration by a third researcher. Results In 82 studies, 26 distinct autoML platforms featured. Brain and lung disease were the most common fields of study of 22 specialties. AutoML exhibited variable performance: AUCROC 0.35-1.00, F1-score 0.16-0.99, AUCPR 0.51-1.00. AutoML exhibited the highest AUCROC in 75.6% trials; the highest F1-score in 42.3% trials; and the highest AUCPRC in 83.3% trials. In autoML platform comparisons, AutoPrognosis and Amazon Rekognition performed strongest with unstructured and structured data respectively. Quality of reporting was poor, with a median DECIDE-AI score of 14 of 27. Conclusions A myriad of autoML platforms have been applied in a variety of clinical contexts. The performance of autoML compares well to bespoke computational and clinical benchmarks. Further work is required to improve the quality of validation studies. AutoML may facilitate a transition to data-centric development, and integration with large language models may enable AI to build itself to fulfil user-defined goals.

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Section: Resultsmentioning

confidence: 99%

Clinical performance of automated machine learning: a systematic review

Thirunavukarasu,

Elangovan,

Gutierrez

et al. 2023

Preprint

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“…We also wish to highlight the relationship of our MLDP approach to automated machine learning (AutoML) approaches ( 30 , 55 ). AutoML optimizes data preparation and ML classifier hyperparameters together.…”

Section: Discussionmentioning

confidence: 99%

Automated data preparation for in vivo tumor characterization with machine learning

et al. 2022

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BackgroundThis study proposes machine learning-driven data preparation (MLDP) for optimal data preparation (DP) prior to building prediction models for cancer cohorts.MethodsA collection of well-established DP methods were incorporated for building the DP pipelines for various clinical cohorts prior to machine learning. Evolutionary algorithm principles combined with hyperparameter optimization were employed to iteratively select the best fitting subset of data preparation algorithms for the given dataset. The proposed method was validated for glioma and prostate single center cohorts by 100-fold Monte Carlo (MC) cross-validation scheme with 80-20% training-validation split ratio. In addition, a dual-center diffuse large B-cell lymphoma (DLBCL) cohort was utilized with Center 1 as training and Center 2 as independent validation datasets to predict cohort-specific clinical endpoints. Five machine learning (ML) classifiers were employed for building prediction models across all analyzed cohorts. Predictive performance was estimated by confusion matrix analytics over the validation sets of each cohort. The performance of each model with and without MLDP, as well as with manually-defined DP were compared in each of the four cohorts.ResultsSixteen of twenty established predictive models demonstrated area under the receiver operator characteristics curve (AUC) performance increase utilizing the MLDP. The MLDP resulted in the highest performance increase for random forest (RF) (+0.16 AUC) and support vector machine (SVM) (+0.13 AUC) model schemes for predicting 36-months survival in the glioma cohort. Single center cohorts resulted in complex (6-7 DP steps) DP pipelines, with a high occurrence of outlier detection, feature selection and synthetic majority oversampling technique (SMOTE). In contrast, the optimal DP pipeline for the dual-center DLBCL cohort only included outlier detection and SMOTE DP steps.ConclusionsThis study demonstrates that data preparation prior to ML prediction model building in cancer cohorts shall be ML-driven itself, yielding optimal prediction models in both single and multi-centric settings.

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“…Hasimbegovic et al used data from 532 patients who were enrolled in the VIenna CardioThOracic Aortic Valve RegistrY (VICTORY). They developed a machine learning-based approach for predicting the decision for TAVR versus surgical aortic valve replacement, which performed excellently (AUC 0.91 with 90% accuracy, 92% sensitivity and 90% specificity), demonstrating that machine learning can tap into the studying and understanding of complex clinical decision-making processes [13].…”

Section: Patient Selectionmentioning

confidence: 99%

Artificial Intelligence in Transcatheter Aortic Valve Replacement: Its Current Role and Ongoing Challenges

Benjamin,

Rabbat

2024

Diagnostics

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Transcatheter aortic valve replacement (TAVR) has emerged as a viable alternative to surgical aortic valve replacement, as accumulating clinical evidence has demonstrated its safety and efficacy. TAVR indications have expanded beyond high-risk or inoperable patients to include intermediate and low-risk patients with severe aortic stenosis. Artificial intelligence (AI) is revolutionizing the field of cardiology, aiding in the interpretation of medical imaging and developing risk models for at-risk individuals and those with cardiac disease. This article explores the growing role of AI in TAVR procedures and assesses its potential impact, with particular focus on its ability to improve patient selection, procedural planning, post-implantation monitoring and contribute to optimized patient outcomes. In addition, current challenges and future directions in AI implementation are highlighted.

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A Sneak-Peek into the Physician’s Brain: A Retrospective Machine Learning-Driven Investigation of Decision-Making in TAVR versus SAVR for Young High-Risk Patients with Severe Symptomatic Aortic Stenosis

Cited by 10 publications

References 56 publications

Clinical performance of automated machine learning: a systematic review

Clinical performance of automated machine learning: a systematic review

Automated data preparation for in vivo tumor characterization with machine learning

Artificial Intelligence in Transcatheter Aortic Valve Replacement: Its Current Role and Ongoing Challenges

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