Artificial Learning and Machine Learning Decision Guidance Applications in Total Hip and Knee Arthroplasty: A Systematic Review

Background: Artificial intelligence (AI) and machine learning (ML) modeling in hip and knee arthroplasty (total joint arthroplasty [TJA]) is becoming more commonplace. This systematic review aims to quantify the accuracy of current AI- and ML-based application for cognitive support and decision-maki...

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Autores principales:	Cesar D. Lopez, BS, Anastasia Gazgalis, BS, Venkat Boddapati, MD, Roshan P. Shah, MD, H. John Cooper, MD, Jeffrey A. Geller, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Machine learning Artificial intelligence Deep learning Artificial neural networks Orthopedic surgery Hip and knee arthroplasty RD701-811
Acceso en línea:	https://doaj.org/article/b3bec2b6eaf7441792e10982e566bd6e
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spelling	oai:doaj.org-article:b3bec2b6eaf7441792e10982e566bd6e2021-11-14T04:33:53ZArtificial Learning and Machine Learning Decision Guidance Applications in Total Hip and Knee Arthroplasty: A Systematic Review2352-344110.1016/j.artd.2021.07.012https://doaj.org/article/b3bec2b6eaf7441792e10982e566bd6e2021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352344121001308https://doaj.org/toc/2352-3441Background: Artificial intelligence (AI) and machine learning (ML) modeling in hip and knee arthroplasty (total joint arthroplasty [TJA]) is becoming more commonplace. This systematic review aims to quantify the accuracy of current AI- and ML-based application for cognitive support and decision-making in TJA. Methods: A comprehensive search of publications was conducted through the EMBASE, Medline, and PubMed databases using relevant keywords to maximize the sensitivity of the search. No limits were placed on level of evidence or timing of the study. Findings were reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Analysis of variance testing with post-hoc Tukey test was applied to compare the area under the curve (AUC) of the models. Results: After application of inclusion and exclusion criteria, 49 studies were included in this review. The application of AI/ML-based models and average AUC is as follows: cost prediction-0.77, LOS and discharges-0.78, readmissions and reoperations-0.66, preoperative patient selection/planning-0.79, adverse events and other postoperative complications-0.84, postoperative pain-0.83, postoperative patient-reported outcomes measures and functional outcome-0.81. Significant variability in model AUC across the different decision support applications was found (P < .001) with the AUC for readmission and reoperation models being significantly lower than that of the other decision support categories. Conclusions: AI/ML-based applications in TJA continue to expand and have the potential to optimize patient selection and accurately predict postoperative outcomes, complications, and associated costs. On average, the AI/ML models performed best in predicting postoperative complications, pain, and patient-reported outcomes and were less accurate in predicting hospital readmissions and reoperations.Cesar D. Lopez, BSAnastasia Gazgalis, BSVenkat Boddapati, MDRoshan P. Shah, MDH. John Cooper, MDJeffrey A. Geller, MDElsevierarticleMachine learningArtificial intelligenceDeep learningArtificial neural networksOrthopedic surgeryHip and knee arthroplastyOrthopedic surgeryRD701-811ENArthroplasty Today, Vol 11, Iss , Pp 103-112 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Machine learning Artificial intelligence Deep learning Artificial neural networks Orthopedic surgery Hip and knee arthroplasty Orthopedic surgery RD701-811
spellingShingle	Machine learning Artificial intelligence Deep learning Artificial neural networks Orthopedic surgery Hip and knee arthroplasty Orthopedic surgery RD701-811 Cesar D. Lopez, BS Anastasia Gazgalis, BS Venkat Boddapati, MD Roshan P. Shah, MD H. John Cooper, MD Jeffrey A. Geller, MD Artificial Learning and Machine Learning Decision Guidance Applications in Total Hip and Knee Arthroplasty: A Systematic Review
description	Background: Artificial intelligence (AI) and machine learning (ML) modeling in hip and knee arthroplasty (total joint arthroplasty [TJA]) is becoming more commonplace. This systematic review aims to quantify the accuracy of current AI- and ML-based application for cognitive support and decision-making in TJA. Methods: A comprehensive search of publications was conducted through the EMBASE, Medline, and PubMed databases using relevant keywords to maximize the sensitivity of the search. No limits were placed on level of evidence or timing of the study. Findings were reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Analysis of variance testing with post-hoc Tukey test was applied to compare the area under the curve (AUC) of the models. Results: After application of inclusion and exclusion criteria, 49 studies were included in this review. The application of AI/ML-based models and average AUC is as follows: cost prediction-0.77, LOS and discharges-0.78, readmissions and reoperations-0.66, preoperative patient selection/planning-0.79, adverse events and other postoperative complications-0.84, postoperative pain-0.83, postoperative patient-reported outcomes measures and functional outcome-0.81. Significant variability in model AUC across the different decision support applications was found (P < .001) with the AUC for readmission and reoperation models being significantly lower than that of the other decision support categories. Conclusions: AI/ML-based applications in TJA continue to expand and have the potential to optimize patient selection and accurately predict postoperative outcomes, complications, and associated costs. On average, the AI/ML models performed best in predicting postoperative complications, pain, and patient-reported outcomes and were less accurate in predicting hospital readmissions and reoperations.
format	article
author	Cesar D. Lopez, BS Anastasia Gazgalis, BS Venkat Boddapati, MD Roshan P. Shah, MD H. John Cooper, MD Jeffrey A. Geller, MD
author_facet	Cesar D. Lopez, BS Anastasia Gazgalis, BS Venkat Boddapati, MD Roshan P. Shah, MD H. John Cooper, MD Jeffrey A. Geller, MD
author_sort	Cesar D. Lopez, BS
title	Artificial Learning and Machine Learning Decision Guidance Applications in Total Hip and Knee Arthroplasty: A Systematic Review
title_short	Artificial Learning and Machine Learning Decision Guidance Applications in Total Hip and Knee Arthroplasty: A Systematic Review
title_full	Artificial Learning and Machine Learning Decision Guidance Applications in Total Hip and Knee Arthroplasty: A Systematic Review
title_fullStr	Artificial Learning and Machine Learning Decision Guidance Applications in Total Hip and Knee Arthroplasty: A Systematic Review
title_full_unstemmed	Artificial Learning and Machine Learning Decision Guidance Applications in Total Hip and Knee Arthroplasty: A Systematic Review
title_sort	artificial learning and machine learning decision guidance applications in total hip and knee arthroplasty: a systematic review
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/b3bec2b6eaf7441792e10982e566bd6e
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Artificial Learning and Machine Learning Decision Guidance Applications in Total Hip and Knee Arthroplasty: A Systematic Review

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