A Machine Learning Approach to First Pass Reperfusion in Mechanical Thrombectomy: Prediction and Feature Analysis.
Publication/Presentation Date
7-1-2021
Abstract
INTRODUCTION: Novel machine learning (ML) methods are being investigated across medicine for their predictive capabilities while boasting increased adaptability and generalizability. In our study, we compare logistic regression with machine learning for feature importance analysis and prediction in first-pass reperfusion.
METHODS: We retrospectively identified cases of ischemic stroke treated with mechanical thrombectomy (MT) at our institution from 2012-2018. Significant variables used in predictive modeling were demographic characteristics, medical history, admission NIHSS, and stroke characteristics. Outcome was binarized TICI on first pass (0-2a vs 2b-3). Shapley feature importance plots were used to identify variables that strongly affected outcomes.
RESULTS: Accuracy for the Random Forest and SVM models were 67.1% compared to 65.8% for the logistic regression model. Brier score was lower for the Random Forest model (0.329 vs 0.342) indicating better predictive capability. Other supervised learning models performed worse than the logistic regression model, with accuracy of 56.2% for Naïve Bayes and 61.6% for XGBoost. Shapley plots for the Random Forest model showed use of aspiration, hyperlipidemia, hypertension, use of stent retriever, and time between symptom onset and catheterization as the top five predictors of first pass reperfusion.
CONCLUSION: Use of machine learning models, such as Random Forest, for the study of MT outcomes, is more accurate than logistic regression for our dataset, and identifies new factors that contribute to achieving first pass reperfusion. The benefits of machine learning, such as improved predictive capabilities, integration of new data, and generalizability, establish ML as the preferred model for studying outcomes in stroke.
Volume
30
Issue
7
First Page
105796
Last Page
105796
ISSN
1532-8511
Published In/Presented At
Velagapudi, L., Mouchtouris, N., Schmidt, R. F., Vuong, D., Khanna, O., Sweid, A., Sadler, B., Al Saiegh, F., Gooch, M. R., Jabbour, P., Rosenwasser, R. H., & Tjoumakaris, S. (2021). A Machine Learning Approach to First Pass Reperfusion in Mechanical Thrombectomy: Prediction and Feature Analysis. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 30(7), 105796. https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105796
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
33887664
Department(s)
Administration and Leadership
Document Type
Article