Skip to main content

Machine learning methods applied to risk adjustment of cumulative sum chart methodology to audit free flap outcomes after head and neck surgery

Tighe, David, McMahon, Jeremy, Schilling, Clare, Ho, Michael, Provost, Simon, Freitas, Alex A. (2022) Machine learning methods applied to risk adjustment of cumulative sum chart methodology to audit free flap outcomes after head and neck surgery. The British Journal of Oral & Maxillofacial Surgery, . ISSN 1532-1940. (doi:10.1016/j.bjoms.2022.09.007) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:98476)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided. (Contact us about this Publication)
Official URL:
https://doi.org/10.1016/j.bjoms.2022.09.007

Abstract

We describe a risk adjustment algorithm to benchmark and report free flap failure rates after immediate reconstruction of head and neck defects. A dataset of surgical care episodes for curative surgery for head and neck cancer and immediate reconstruction (n = 1593) was compiled from multiple NHS hospitals (n = 8). The outcome variable was complete flap failure. Classification models using preoperative patient demographic data, operation data, functional status data and tumour stage data, were built. Machine learning processes are described to model free flap failure. Overall complete flap failure was uncommon (4.7%) with a non-statistical difference seen between hospitals. The champion predictive model had acceptable discrimination (AUROC 0.66). This model was used to risk-adjust cumulative sum (CuSUM) charts. The use of CuSUM charts is a viable way to monitor in a 'Live Dashboard' this quality metric as part of the quality outcomes in oral and maxillofacial surgery audit.

Item Type: Article
DOI/Identification number: 10.1016/j.bjoms.2022.09.007
Projects: Machine learning applied to the audit of outcome after head and neck surgery (free flap data) Project code: 17711
Additional information: ** From PubMed via Jisc Publications Router ** History: received 17-08-2022; revised 20-09-2022; accepted 22-09-2022.
Uncontrolled keywords: Neck, Outcome, Free flap failure, Audit, Head
Subjects: Q Science > QA Mathematics (inc Computing science) > QA 76 Software, computer programming,
R Medicine
Divisions: Divisions > Division of Computing, Engineering and Mathematical Sciences > School of Computing
Funders: East Kent Hospitals University NHS Foundation Trust (https://ror.org/02dqqj223)
SWORD Depositor: JISC Publications Router
Depositing User: JISC Publications Router
Date Deposited: 02 Dec 2022 11:43 UTC
Last Modified: 06 Dec 2022 10:28 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/98476 (The current URI for this page, for reference purposes)

University of Kent Author Information

  • Depositors only (login required):

Total unique views for this document in KAR since July 2020. For more details click on the image.