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Short Communication
Mathematical modeling and prediction of the effectiveness of surgical treatment in surgery of the spine and pelvic complex
L. Yu. Kossovicha,
A. V. Kharlamova,
Yu. V. Lysunkinaa,
A. E. Shulgab a N. G. Chernyshevsky Saratov State University (National Research University),
Saratov, 410012, Russian Federation
b Research Institute of Traumatology, Orthopedics, and Neurosurgery,
Saratov State Medical University named after V. I. Razumovsky,
Saratov, 410012, Russian Federation.
Abstract:
Based on the study of the literature on the quality assessment of operative
treatment in reconstructive surgery of the spine and pelvic complex, it can be
concluded that, as a rule, multiple linear or logistic regression, a
decision tree, is used to predict the quality of operative treatment. Neural
networks are less commonly used.
Forecasting is performed on the basis of a comparison of the pre- and
postoperative condition of the patient, assessed according to various
ordinal and quantitative scales as a result of interviewing the patient.
With a relatively small number of analyzed cases of the disease (several
tens or hundreds) and a small number of indicators (no more than two or
three dozen), the use of neural networks seems premature for two reasons: a
small amount of data allows analyzing them with classical methods of
mathematical statistics, and identifying dependencies on a given stage
requires constant “manual” intervention, taking into account information
from the subject area.
The application of statistical analysis methods to data on the treatment of
chronic injuries showed the presence of standard problems for medical data.
This is the presentation of the initial information in nominal or ordinal
scales, the subjective nature of some indicators, as well as the
interdependence of the presented characteristics, which reduces the quality
of research.
The search for the objective function that characterizes the quality of
surgical treatment has shown the ambiguity of solving this problem even for
a highly specialized situation.
The identification of objectively present relationships also revealed a
large number of problems, especially related to the choice of the type of
surgical treatment, which is largely determined by the experience of the
surgeon.
Based on the study, it was proposed to build a model for predicting the
quality of surgical treatment, based on expert assessments in the form of a
forecast tree with recommended surgical treatment options and a statistical
forecast based on the available experience. It is assumed that the model
will be dynamic with feedback and be able to self-update.
To predict the quality of surgical treatment in reconstructive surgery of
the spine and pelvic complex, it is advisable to use a forecast tree, which allows us
to recommend the type of surgery for a specific case of injury or disease
and calculate the predicted values of quality of life indicators.
Keywords:
evaluation of the effectiveness of treatment, prognosis of treatment, decision support.
UDC:
519.248:[159.9+57+61]
MSC: 62P10 Received: May 13, 2019Revised: September 16, 2019Accepted: November 11, 2019First online: December 20, 2019
Language: English
DOI:
10.14498/vsgtu1702