Big data are no longer an obstacle; now, by using artificial intelligence (AI), previously undiscovered knowledge can be found in massive data collections. The radiation oncology clinic daily produces a large amount of multisource data and metadata during its routine clinical and research activities. These data involve multiple stakeholders and users. Because of a lack of interoperability, most of these data remain unused, and powerful insights that could improve patient care are lost. Changing the paradigm by introducing powerful AI analytics and a common vision for empowering big data in radiation oncology is imperative. However, this can only be achieved by creating a clinical data science community in radiation oncology. In this work, we present why such a community is needed to translate multisource data into clinical decision aids.
To explore the association between preoperative physical performance with short-and long-term postoperative outcomes in patients undergoing lumbar spinal fusion (LSF). Design: Retrospective cohort. Setting: University hospital. Participants: Seventy-seven patients (N=77) undergoing elective LSF were preoperatively screened on patient demographics, patient-reported outcome measures, and physical performance measures (movement control, back muscle endurance strength and extensor strength, aerobic capacity, flexibility). Interventions: Not applicable. Main Outcome Measures: Associations between preoperative variables and inpatient functional recovery, hospital length of stay (LOS), and 1-to 2-year postoperative pain reduction were explored using random forest analyses assessing the relative influence of the variable on the outcome. Results: Aerobic capacity was associated with fast functional recovery <4 days and prolonged functional recovery >5 days (median z scores=7.1 and 12.0). Flexibility (median z score=4.3) and back muscle endurance strength (median z score=7.8) were associated with fast functional recovery <4 days. Maximum back extensor strength was associated with prolonged functional recovery >5 days (median z score=8.6). Flexibility (median z score=5.1) and back muscle endurance strength (median z score=13.5) were associated with short LOS <5 days. Aerobic capacity (median z score=8.7) was associated with prolonged LOS >7 days. Maximum back extensor strength (median z score=3.8) was associated with 1-to 2-year postoperative pain reduction and aerobic capacity (median z score=2.8) was tentative. Conclusions: Physical performance measures were associated with both short-and long-term outcomes after LSF. Adding these measures to prediction models predicting outcomes after LSF may increase their accuracy.
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