Machine Learning Algorithms Using Logistic Regression for Predicting Neurosurgical Outcomes

Abstract

Background: Preoperative prognostication of clinical and surgical outcome in patients with neurosurgical diseases can improve the risk stratification, thus can guide in implementing targeted treatment to minimize these events. Therefore, the author aims to highlight the development and validation of predictive models determining neurosurgical outcomes through machine learning algorithms using logistic regression.Methods: Logistic regression (enter, backward and forward) and least absolute shrinkage and selection operator (LASSO) method for selection of variables from selected database can eventually lead to multiple candidate models. The final model with a set of predictive variables must be selected based upon the clinical knowledge and numerical results.Results: The predictive model which performed best on the discrimination, calibration, Brier score and decision curve analysis must be selected to develop machine learning algorithms. Logistic regression should be compared with the LASSO model. Usually for the big databases, the predictive model selected through logistic regression gives higher Area Under the Curve (AUC) than those with LASSO model. The predictive probability derived from the best model could be uploaded to an open access web application which is easily deployed by the patients and surgeons to make a risk assessment world-wide.Conclusions: Machine learning algorithms provide promising results for the prediction of outcomes following cranial and spinal surgery. These algorithms can provide useful factors for patient-counselling, assessing peri-operative risk factors, and predicting post-operative outcomes after neurosurgery.