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Deep Learning to Predict Traumatic Brain Injury Outcomes in the Low-Resource Setting.

Publication ,  Journal Article
Adil, SM; Elahi, C; Patel, DN; Seas, A; Warman, PI; Fuller, AT; Haglund, MM; Dunn, TW
Published in: World Neurosurg
August 2022

OBJECTIVE: Traumatic brain injury (TBI) disproportionately affects low- and middle-income countries (LMICs). In these settings, accurate patient prognostication is both difficult and essential for high-quality patient care. With the ultimate goal of enhancing TBI triage in LMICs, we aim to develop the first deep learning model to predict outcomes after TBI and compare its performance with that of less complex algorithms. METHODS: TBI patients' data were prospectively collected in Kampala, Uganda, from 2016 to 2020. To predict good versus poor outcome at hospital discharge, we created deep neural network, shallow neural network, and elastic-net regularized logistic regression models. Predictors included 13 easily acquirable clinical variables. We assessed model performance with 5-fold cross-validation to calculate areas under both the receiver operating characteristic curve and precision-recall curve (AUPRC), in addition to standardized partial AUPRC to focus on comparisons at clinically relevant operating points. RESULTS: We included 2164 patients for model training, of which 12% had poor outcomes. The deep neural network performed best as measured by the area under the receiver operating characteristic curve (0.941) and standardized partial AUPRC in region maximizing recall (0.291), whereas the shallow neural network was best by the area under the precision-recall curve (0.770). In several other comparisons, the elastic-net regularized logistic regression was noninferior to the neural networks. CONCLUSIONS: We present the first use of deep learning for TBI prognostication, with an emphasis on LMICs, where there is great need for decision support to allocate limited resources. Optimal algorithm selection depends on the specific clinical setting; deep learning is not a panacea, though it may have a role in these efforts.

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Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

August 2022

Volume

164

Start / End Page

e8 / e16

Location

United States

Related Subject Headings

  • Uganda
  • ROC Curve
  • Logistic Models
  • Humans
  • Deep Learning
  • Brain Injuries, Traumatic
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences
 

Citation

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Chicago
ICMJE
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Adil, S. M., Elahi, C., Patel, D. N., Seas, A., Warman, P. I., Fuller, A. T., … Dunn, T. W. (2022). Deep Learning to Predict Traumatic Brain Injury Outcomes in the Low-Resource Setting. World Neurosurg, 164, e8–e16. https://doi.org/10.1016/j.wneu.2022.02.097
Adil, Syed M., Cyrus Elahi, Dev N. Patel, Andreas Seas, Pranav I. Warman, Anthony T. Fuller, Michael M. Haglund, and Timothy W. Dunn. “Deep Learning to Predict Traumatic Brain Injury Outcomes in the Low-Resource Setting.World Neurosurg 164 (August 2022): e8–16. https://doi.org/10.1016/j.wneu.2022.02.097.
Adil SM, Elahi C, Patel DN, Seas A, Warman PI, Fuller AT, et al. Deep Learning to Predict Traumatic Brain Injury Outcomes in the Low-Resource Setting. World Neurosurg. 2022 Aug;164:e8–16.
Adil, Syed M., et al. “Deep Learning to Predict Traumatic Brain Injury Outcomes in the Low-Resource Setting.World Neurosurg, vol. 164, Aug. 2022, pp. e8–16. Pubmed, doi:10.1016/j.wneu.2022.02.097.
Adil SM, Elahi C, Patel DN, Seas A, Warman PI, Fuller AT, Haglund MM, Dunn TW. Deep Learning to Predict Traumatic Brain Injury Outcomes in the Low-Resource Setting. World Neurosurg. 2022 Aug;164:e8–e16.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

August 2022

Volume

164

Start / End Page

e8 / e16

Location

United States

Related Subject Headings

  • Uganda
  • ROC Curve
  • Logistic Models
  • Humans
  • Deep Learning
  • Brain Injuries, Traumatic
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences