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Machine learning methods applied to audit of surgical margins after curative surgery for facial (non-melanoma) skin cancer

Tighe, David, Tekeli, Kemal, Gouk, Tara, Smith, Jennifer, Ho, Michael, Moody, Andrew, Walsh, Stephen, Provost, Simon, Freitas, Alex A. (2023) Machine learning methods applied to audit of surgical margins after curative surgery for facial (non-melanoma) skin cancer. The British Journal of Oral & Maxillofacial Surgery, 61 (1). pp. 94-100. ISSN 1532-1940. (doi:10.1016/j.bjoms.2022.11.280) (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:99689)

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Official URL:
https://doi.org/10.1016/j.bjoms.2022.11.280

Abstract

We aimed to build a model to predict positive margin status after curative excision of facial non-melanoma skin cancer based on known risk factors that contribute to the complexity of the case mix. A pathology output of consecutive histology reports was requested from three oral and maxillofacial units in the south east of England. The dependent variable was a deep margin with peripheral margin clearance at a 0.5 mm threshold. A total of 3354 cases were analysed. Positivity of either the peripheral or deep margin for both squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) was 15.4% at Unit 1, 21.1% at Unit 2, and 15.4% at Unit 3. Predictive models accounting for patient and tumour factors were developed using automated machine learning methods. The champion models demonstrated good discrimination for predicting margin status after excision of BCCs (AUROC = 0.67) and SCCs (AUROC = 0.71). We demonstrate that rates of positive excision margins of facial non-melanoma skin cancer (fNMSC), when adjusted by the risk prediction model, can be used to compare unit performance fairly once variations in tumour factors and patient factors are accounted for.

Item Type: Article
DOI/Identification number: 10.1016/j.bjoms.2022.11.280
Uncontrolled keywords: Outcomes, Non-melanoma skin cancer, Audit, Surgical margin
Subjects: Q Science > QA Mathematics (inc Computing science)
Q Science > QA Mathematics (inc Computing science) > QA 75 Electronic computers. Computer science
T Technology
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: 27 Jan 2023 15:32 UTC
Last Modified: 30 Jan 2023 12:21 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/99689 (The current URI for this page, for reference purposes)

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