Machine learning in predicting early remission in patients after surgical treatment of acromegaly: a multicenter study
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Machine learning in predicting early remission in patients after surgical treatment of acromegaly: a multicenter study Nidan Qiao1,2,3,4,5 · Ming Shen1,2,4,5 · Wenqiang He1,2,4,5 · Min He6 · Zhaoyun Zhang6 · Hongying Ye6 · Yiming Li6 · Xuefei Shou1,2,4,5 · Shiqi Li1,2,4,5 · Changzhen Jiang7 · Yongfei Wang1,2,4,5 · Yao Zhao1,2,4,5,8,9 Accepted: 19 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Accurate prediction of postoperative remission is beneficial for effective patient-physician communication in acromegalic patients. This study aims to train and validate machine learning prediction models for early endocrine remission of acromegalic patients. Methods The training cohort included 833 patients with growth hormone (GH) secreting pituitary adenoma from 2010 to 2018. We trained a partial model (only using pre-operative variables) and a full model (using all variables) to predict offmedication endocrine remission at six-month follow-up after surgery using multiple algorithms. The models were validated in 99 prospectively collected patients from a second campus and 52 patients from a third institution. Results C-statistic and the accuracy of the best partial model was 0.803 (95% CI 0.757–0.849) and 72.5% (95% CI 67.6– 77.5%), respectively. C-statistic and the accuracy of the best full model was 0.888 (95% CI 0.861–0.914) and 80.3% (95% CI 77.5–83.1%), respectively. The c-statistics (and accuracy) of using only Knosp grade, total resection, or postoperative day 1 GH level as the single predictor were lower than our partial model or full model (p < 0.001). C-statistics remained similar in the prospective cohort (partial model 0.798, and full model 0.903) and in the external cohort (partial model 0.771, and full model 0.871). A web-based application integrated with the trained models was published at https://deepvep.shiny apps.io/Acropred/. Conclusion We developed and validated interpretable and applicable machine learning models to predict early endocrine remission after surgical resection of a GH-secreting pituitary adenoma. Predication accuracy of the trained models were better than those using single variables. Keywords Prediction · Acromegaly · 2010 consensus · Neural network
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11102-020-01086-4) contains supplementary material, which is available to authorized users. 4
Neurosurgical Institute of Fudan University, Shanghai, China
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* Yongfei Wang [email protected]
Shanghai Pituitary Tumor Center, Shanghai, China
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* Yao Zhao [email protected]
Department of Endocrinology, Shanghai Medical School, Huashan Hospital, Fudan University, Shanghai, China
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Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fujian Medical University, 20 Chazhong Road, Fujian, China
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State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
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National Clinical Research Center for Aging and Me
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