Evidence map›Paper›PMID 39189482›Full record

ArticleJournal of the American Heart Association2024

Using Machine Learning to Predict Outcomes Following Transfemoral Carotid Artery Stenting.

Ben Li, Naomi Eisenberg, Derek Beaton, Douglas S Lee, Leen Al-Omran, Duminda N Wijeysundera, Mohamad A Hussain, Ori D Rotstein, Charles de Mestral, Muhammad Mamdani and 2 more

Abstract read
In one paragraph

Article in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ben LiDepartment of Surgery University of Toronto Ontario Canada.ORCID 0000-0002-7191-1034
Naomi EisenbergDivision of Vascular Surgery, Peter Munk Cardiac Centre University Health Network Toronto Ontario Canada.ORCID 0000-0002-1237-9244
Derek BeatonData Science & Advanced Analytics, Unity Health Toronto University of Toronto Ontario Canada.ORCID 0000-0001-6118-4366
Douglas S LeeDivision of Cardiology, Peter Munk Cardiac Centre University Health Network Toronto Ontario Canada.ORCID 0000-0001-7078-745X
Leen Al-OmranSchool of Medicine Alfaisal University Riyadh Saudi Arabia.
Duminda N WijeysunderaInstitute of Health Policy, Management and Evaluation, University of Toronto Ontario Canada.ORCID 0000-0002-5897-8605
Mohamad A HussainDivision of Vascular and Endovascular Surgery and the Center for Surgery and Public Health Brigham and Women's Hospital, Harvard Medical School Boston MA USA.ORCID 0000-0003-2471-8167
Ori D RotsteinDepartment of Surgery University of Toronto Ontario Canada.ORCID 0009-0004-4388-5352
Charles de MestralDepartment of Surgery University of Toronto Ontario Canada.ORCID 0000-0001-7177-7480
Muhammad MamdaniInstitute of Medical Science, University of Toronto Ontario Canada.ORCID 0000-0001-5199-6344
Graham Roche-NagleDepartment of Surgery University of Toronto Ontario Canada.ORCID 0000-0002-3560-6788
Mohammed Al-OmranDepartment of Surgery University of Toronto Ontario Canada.ORCID 0000-0003-3325-0420

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransfemoral carotid artery stenting (TFCAS) carries important perioperative risks. Outcome prediction tools may help guide clinical decision-making but remain limited. We developed machine learning algorithms that predict 1-year stroke or death following TFCAS. METHODS AND

resultsThe VQI (Vascular Quality Initiative) database was used to identify patients who underwent TFCAS for carotid artery stenosis between 2005 and 2024. We identified 112 features from the index hospitalization (82 preoperative [demographic/clinical], 13 intraoperative [procedural], and 17 postoperative [in-hospital course/complications]). The primary outcome was 1-year postprocedural stroke or death. The data were divided into training (70%) and test (30%) sets. Six machine learning models were trained using preoperative features with 10-fold cross-validation. The primary model evaluation metric was area under the receiver operating characteristic curve. The algorithm with the best performance was further trained using intra- and postoperative features. Model robustness was assessed using calibration plots and Brier scores. Overall, 35 214 patients underwent TFCAS during the study period and 3257 (9.2%) developed 1-year stroke or death. The best preoperative prediction model was extreme gradient boosting, achieving an area under the receiver operating characteristic curve of 0.94 (95% CI, 0.93-0.95). In comparison, logistic regression had an AUROC of 0.65 (95% CI, 0.63-0.67). The extreme gradient boosting model maintained excellent performance at the intra- and postoperative stages, with area under the receiver operating characteristic curve values of 0.94 (95% CI, 0.93-0.95) and 0.98 (95% CI, 0.97-0.99), respectively. Calibration plots showed good agreement between predicted/observed event probabilities with Brier scores of 0.11 (preoperative), 0.11 (intraoperative), and 0.09 (postoperative).

conclusionsMachine learning can accurately predict 1-year stroke or death following TFCAS, performing better than logistic regression.

Indexed as

Carotid StenosisFemoral ArteryMachine LearningStentsStrokeAgedAged, 80 and overDatabases, FactualEndovascular ProceduresFemaleHumansMaleMiddle AgedPredictive Value of TestsRetrospective StudiesRisk Assessmentdeathmachine learningpredictionstroketransfemoral carotid artery stenting

Identifiers

PMID39189482
PMCPMC11646515

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.