Dosimetric Planning Tradeoffs to Reduce Heart Dose Using Machine Learning-Guided Decision Support Software in Patients with Lung Cancer

PURPOSE Early identification of patients who may be at high risk of significant weight loss (SWL) is important for timely clinical intervention in lung cancer radiotherapy (RT). A clinical decision support system (CDSS) for SWL prediction was implemented within the routine clinical workflow and assessed on a prospective cohort of patients. MATERIALS AND METHODS CDSS incorporated a machine learning prediction model on the basis of radiomics and dosiomics image features and was connected to a web-based dashboard for streamlined patient enrollment, feature extraction, SWL prediction, and physicians' evaluation processes. Patients with lung cancer (N = 37) treated with definitive RT without prior RT were prospectively enrolled in the study. Radiomics and dosiomics features were extracted from CT and 3D dose volume, and SWL probability (≥ 0.5 considered as SWL) was predicted. Two physicians predicted whether the patient would have SWL before and after reviewing the CDSS prediction. The physician's prediction performance without and with CDSS and prediction changes before and after using CDSS were compared. RESULTS CDSS showed significantly better prediction accuracy than physicians (0.73 v 0.54) with higher specificity (0.81 v 0.50) but with lower sensitivity (0.55 v 0.64). Physicians changed their original prediction after reviewing CDSS prediction for four cases (three correctly and one incorrectly), for all of which CDSS prediction was correct. Physicians' prediction was improved with CDSS in accuracy (0.54-0.59), sensitivity (0.64-0.73), specificity (0.50-0.54), positive predictive value (0.35-0.40), and negative predictive value (0.76-0.82). CONCLUSION Machine learning–based CDSS showed the potential to improve SWL prediction in lung cancer RT. More investigation on a larger patient cohort is needed to properly interpret CDSS prediction performance and its benefit in clinical decision making.

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Review of classification studies for machine learning in the development of intelligent management decision support systems

Technology of technosphere safety ◽

10.25257/tts.2020.3.89.20-29 ◽

2020 ◽

Vol 89 ◽

pp. 20-29

Author(s):

Sh. K. Kadiev ◽

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R. Sh. Khabibulin ◽

P. P. Godlevskiy ◽

V. L. Semikov ◽

...

Keyword(s):

Machine Learning ◽

Decision Support ◽

Mathematical Models ◽

Decision Support Systems ◽

Support Systems ◽

Management Decision ◽

Classification Methods ◽

Advantages And Disadvantages ◽

Intelligent Management ◽

Management Decision Support

Introduction. An overview of research in the field of classification as a method of machine learning is given. Articles containing mathematical models and algorithms for classification were selected. The use of classification in intelligent management decision support systems in various subject areas is also relevant. Goal and objectives. The purpose of the study is to analyze papers on the classification as a machine learning method. To achieve the objective, it is necessary to solve the following tasks: 1) to identify the most used classification methods in machine learning; 2) to highlight the advantages and disadvantages of each of the selected methods; 3) to analyze the possibility of using classification methods in intelligent systems to support management decisions to solve issues of forecasting, prevention and elimination of emergencies. Methods. To obtain the results, general scientific and special methods of scientific knowledge were used - analysis, synthesis, generalization, as well as the classification method. Results and discussion thereof. According to the results of the analysis, studies with a mathematical formulation and the availability of software developments were identified. The issues of classification in the implementation of machine learning in the development of intelligent decision support systems are considered. Conclusion. The analysis revealed that enough algorithms were used to perform the classification while sorting the acquired knowledge within the subject area. The implementation of an accurate classification is one of the fundamental problems in the development of management decision support systems, including for fire and emergency prevention and response. Timely and effective decision by officials of operational shifts for the disaster management is also relevant. Key words: decision support, analysis, classification, machine learning, algorithm, mathematical models.

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