Comparisons of Prediction Models of Quality of Life after Laparoscopic Cholecystectomy: A Longitudinal Prospective Study

Chong-Chi Chiu,Frank Emmert-Streib,Hao-Hsien Lee,Hon-Yi Shi,King-Teh Lee,Jinn-Tsong Tsai,Chieh-Fan Chen,Wen-Hsien Ho

doi:10.1371/journal.pone.0051285

Abstract

BackgroundFew studies of laparoscopic cholecystectomy (LC) outcome have used longitudinal data for more than two years. Moreover, no studies have considered group differences in factors other than outcome such as age and nonsurgical treatment. Additionally, almost all published articles agree that the essential issue of the internal validity (reproducibility) of the artificial neural network (ANN), support vector machine (SVM), Gaussian process regression (GPR) and multiple linear regression (MLR) models has not been adequately addressed. This study proposed to validate the use of these models for predicting quality of life (QOL) after LC and to compare the predictive capability of ANNs with that of SVM, GPR and MLR.Methodology/Principal FindingsA total of 400 LC patients completed the SF-36 and the Gastrointestinal Quality of Life Index at baseline and at 2 years postoperatively. The criteria for evaluating the accuracy of the system models were mean square error (MSE) and mean absolute percentage error (MAPE). A global sensitivity analysis was also performed to assess the relative significance of input parameters in the system model and to rank the variables in order of importance. Compared to SVM, GPR and MLR models, the ANN model generally had smaller MSE and MAPE values in the training data set and test data set. Most ANN models had MAPE values ranging from 4.20% to 8.60%, and most had high prediction accuracy. The global sensitivity analysis also showed that preoperative functional status was the best parameter for predicting QOL after LC.Conclusions/SignificanceCompared with SVM, GPR and MLR models, the ANN model in this study was more accurate in predicting patient-reported QOL and had higher overall performance indices. Further studies of this model may consider the effect of a more detailed database that includes complications and clinical examination findings as well as more detailed outcome data.

Highlights

Laparoscopic cholecystectomy (LC) is among the most common operations performed by general surgeons
Almost all published articles agree that the essential issue of the internal validity of artificial neural network (ANN), support vector machine (SVM), Gaussian process regression (GPR) and multiple linear regression (MLR) models has not been adequately addressed
The primary aim of this study was to validate the use of ANN models in predicting patient-reported quality of life (QOL) after laparoscopic cholecystectomy (LC) surgery, and the secondary aim was to compare the predictive capability of ANNs with that of SVM, GPR and MLR models

Summary

Introduction

Laparoscopic cholecystectomy (LC) is among the most common operations performed by general surgeons. Artificial neural networks (ANNs) are complex and flexible nonlinear systems with properties not found in other modeling systems These properties include robust performance in dealing with noisy or incomplete input patterns, high fault tolerance, and the capability to generalize from the input data [9,10,11]. Almost all published articles agree that the essential issue of the internal validity (reproducibility) of the artificial neural network (ANN), support vector machine (SVM), Gaussian process regression (GPR) and multiple linear regression (MLR) models has not been adequately addressed. This study proposed to validate the use of these models for predicting quality of life (QOL) after LC and to compare the predictive capability of ANNs with that of SVM, GPR and MLR

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Conclusion