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Natural language processing for the automated detection of intra-operative elements in lumbar spine surgery – Lumbar Spinal Stenosis

This article published in Frontiers in Surgery discusses the development and assessment of natural language processing (NLP) algorithms for automated identification of certain elements in operative notes of patients after lumbar surgery. The study analyzed the operative notes of patients who underwent lumbar discectomy and/or decompression, focusing on incidental durotomy, wound drains, and the use of sutures or skin clips for wound closure. The NLP algorithms achieved high accuracy, specificity, positive predictive value, and area under the receiver-operating curve. They also demonstrated clinical net benefit and highlighted clinically useful features for classifying the presence of each element. The authors suggest that these NLP algorithms can be useful for monitoring surgical performance and complications in lumbar spine surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established spinal clinic on Harley Street UK

Published article

CONCLUSIONS: These NLP algorithms can help monitor surgical performance and complications in an automated fashion by identifying and classifying the presence of various intra-operative elements in lumbar spine surgery.

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Front Surg. 2023 Dec 18;10:1271775. doi: 10.3389/fsurg.2023.1271775. eCollection 2023.ABSTRACTBACKGROUND: The aim of this study was to develop natural language processing (NLP) algorithms to conduct automated identification of incidental durotomy, wound drains, and the use of sutures or skin clips for wound closure, in free text operative notes of patients following lumbar surgery.METHODS: A single-centre retrospective,

Front Surg. 2023 Dec 18;10:1271775. doi: 10.3389/fsurg.2023.1271775. eCollection 2023.

ABSTRACT

BACKGROUND: The aim of this study was to develop natural language processing (NLP) algorithms to conduct automated identification of incidental durotomy, wound drains, and the use of sutures or skin clips for wound closure, in free text operative notes of patients following lumbar surgery.

METHODS: A single-centre retrospective case series analysis was conducted between January 2015 and June 2022, analysing operative notes of patients aged >18 years who underwent a primary lumbar discectomy and/or decompression at any lumbar level. Extreme gradient-boosting NLP algorithms were developed and assessed on five performance metrics: accuracy, area under receiver-operating curve (AUC), positive predictive value (PPV), specificity, and Brier score.

RESULTS: A total of 942 patients were used in the training set and 235 patients, in the testing set. The average age of the cohort was 53.900 ± 16.153 years, with a female predominance of 616 patients (52.3%). The models achieved an aggregate accuracy of >91%, a specificity of >91%, a PPV of >84%, an AUC of >0.933, and a Brier score loss of ≤0.082. The decision curve analysis also revealed that these NLP algorithms possessed great clinical net benefit at all possible threshold probabilities. Global and local model interpretation analyses further highlighted relevant clinically useful features (words) important in classifying the presence of each entity appropriately.

CONCLUSIONS: These NLP algorithms can help monitor surgical performance and complications in an automated fashion by identifying and classifying the presence of various intra-operative elements in lumbar spine surgery.

PMID:38164290 | PMC:PMC10757971 | DOI:10.3389/fsurg.2023.1271775

The London Spine Unit : most established spinal clinic on Harley Street UK

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Natural language processing for the automated detection of intra-operative elements in lumbar spine surgery

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Front Surg. 2023 Dec 18;10:1271775. doi: 10.3389/fsurg.2023.1271775. eCollection 2023.ABSTRACTBACKGROUND: The aim of this study was to develop natural language processing (NLP) algorithms to conduct automated identification of incidental durotomy, wound drains, and the use of sutures or skin clips for wound closure, in free text operative notes of patients following lumbar surgery.METHODS: A single-centre retrospective

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