Key result
An extreme gradient boosting model improved surgical case duration prediction compared to historic EMR averages, achieving an R-squared of 85% and a mean absolute error of 30.2 minutes.
Why the study?
Low predictive accuracy of EMR-based historic averages for surgical case duration leads to negative impacts like surgery rescheduling and cancellation, which motivated using advanced machine learning to improve predictions.
Do advanced machine learning algorithms improve the prediction of operation case duration compared to historic EMR averages?
Observational (n=179,420)
No
Do advanced machine learning algorithms improve the prediction of operation case duration compared to historic EMR averages?
Answers are grounded in this paper and cite their sources.
Extreme gradient boosting machine learning models significantly improve the accuracy of surgical case duration predictions compared to traditional historic averages, potentially optimizing operating room utilization.
Predictive accuracy of surgical case duration plays a critical role in reducing cost of operation room (OR) utilization. The most common approaches used by hospitals rely on historic averages based on a specific surgeon or a specific procedure type obtained from the electronic medical record (EMR) scheduling systems. However, low predictive accuracy of EMR leads to negative impacts on patients and hospitals, such as rescheduling of surgeries and cancellation. In this study, we aim to improve prediction of operation case duration with advanced machine learning (ML) algorithms. We obtained a large data set containing 170,748 operation cases (from Jan 2017 to Dec 2019) from a hospital. The data covered a broad variety of details on patients, operations, specialties and surgical teams. Meanwhile, a more recent data with 8,672 cases (from Mar to Apr 2020) was also available to be used for external evaluation. We computed historic averages from EMR for surgeon- or procedure-specific and they were used as baseline models for comparison. Subsequently, we developed our models using linear regression, random forest and extreme gradient boosting (XGB) algorithms. All models were evaluated with R-squre ( R 2 ), mean absolute error ( MAE ), and percentage overage (case duration > prediction + 10 % & 15 mins), underage (case duration < prediction - 10 % & 15 mins) and within (otherwise). The XGB model was superior to the other models by having higher R 2 (85 %) and percentage within (48 %) as well as lower MAE (30.2 mins). The total prediction errors computed for all the models showed that the XGB model had the lowest inaccurate percent (23.7 %). As a whole, this study applied ML techniques in the field of OR scheduling to reduce medical and financial burden for healthcare management. It revealed the importance of operation and surgeon factors in operation case duration prediction. This study also demonstrated the importance of performing an external evaluation to better validate performance of ML models.
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Huang et al. (2020) conducted an observational in Surgical case duration (n=179,420). Extreme gradient boosting (XGB) model vs. Historic averages from EMR was evaluated on Predictive accuracy (R-square, mean absolute error, and percentage within/overage/underage). An extreme gradient boosting model improved surgical case duration prediction compared to historic EMR averages, achieving an R-squared of 85% and a mean absolute error of 30.2 minutes.
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