Predicting post-discharge cancer surgery complications via telemonitoring of patient-reported outcomes and patient-generated health data

J Surg Oncol. 2021 Apr;123(5):1345-1352. doi: 10.1002/jso.26413. Epub 2021 Feb 23.

Abstract

Background and objectives: Post-discharge oncologic surgical complications are costly for patients, families, and healthcare systems. The capacity to predict complications and early intervention can improve postoperative outcomes. In this proof-of-concept study, we used a machine learning approach to explore the potential added value of patient-reported outcomes (PROs) and patient-generated health data (PGHD) in predicting post-discharge complications for gastrointestinal (GI) and lung cancer surgery patients.

Methods: We formulated post-discharge complication prediction as a binary classification task. Features were extracted from clinical variables, PROs (MD Anderson Symptom Inventory [MDASI]), and PGHD (VivoFit) from a cohort of 52 patients with 134 temporal observation points pre- and post-discharge that were collected from two pilot studies. We trained and evaluated supervised learning classifiers via nested cross-validation.

Results: A logistic regression model with L2 regularization trained with clinical data, PROs and PGHD from wearable pedometers achieved an area under the receiver operating characteristic of 0.74.

Conclusions: PROs and PGHDs captured through remote patient telemonitoring approaches have the potential to improve prediction performance for postoperative complications.

Keywords: machine learning; patient-generated health data; patient-reported outcomes; supervised learning; wearable computing.

MeSH terms

  • Adult
  • Aftercare / standards*
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Machine Learning
  • Male
  • Middle Aged
  • Neoplasms / pathology
  • Neoplasms / surgery*
  • Patient Discharge*
  • Patient Outcome Assessment*
  • Patient Reported Outcome Measures*
  • Postoperative Complications / physiopathology*
  • Predictive Value of Tests
  • Recovery of Function
  • Wireless Technology / instrumentation*
  • Young Adult