To build, train, and assess the artificial neural network (ANN) system in estimatingthe residual valve rate after endoscopic valve ablationand compare the data obtained with conventional analysis. In a retrospective cross-sectional study between June 2010 and December 2020, 144 children with a history of posteriorurethral valve (PUV) who underwent endoscopic valve ablation were enrolled in the study. MATLAB software was used to design and train the network in a feed-forward backpropagationerror adjustment scheme. Preoperative and postoperative data from 101 patients (70%) (training set) were utilized to assessthe impact and relative significance of the necessity for repeatedablation. The validated suitably trained ANN was used to predict repeated ablation in the next 33 patients (22.9%) (test set)whose preoperative data were serially input into the system. To assess system accuracy in forecasting the requirement for repeatablation, projected values were compared to actual outcomes. The likelihood of predicting the residual valve was calculatedusing a three-layered backpropagating deep ANN using preoperativeand postoperative information. Of 144 operated cases, 33 (22.9%) had residual valvesand needs to repeated ablation. The ANN accuracy, sensitivity, and specificity for predicting the residual valve were 90.75%,92.73%, and 73.19%, respectively. Younger age at surgery, hyperechogenicity of the renal parenchyma, presence of vesicoureteralreflux (VUR), and grade of reflux before surgery were among the most significant characteristics that affectedpostoperative outcome variables, the need for repeated ablation, and were given the highest relative weight by the ANN system. Conclusions: The ANN is an integrated data-gathering tool for analyzing and finding relationships among variables as a complex non-linear statistical model. The results indicate that ANN is a valuable tool for outcome prediction of the residualvalveafter endoscopic valve ablation in patients with PUV.
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