External validation of risk prediction platforms for pancreatic fistula after pancreatoduodenectomy using nomograms and artificial intelligence
	    		
		   		
		   			
		   		
	    	
    	 
    	10.4174/astr.2022.102.3.147
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		So Jeong YOON
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Wooil KWON
			        		
			        		;
		        		
		        		
		        		
			        		Ok Joo LEE
			        		
			        		;
		        		
		        		
		        		
			        		Ji Hye JUNG
			        		
			        		;
		        		
		        		
		        		
			        		Yong Chan SHIN
			        		
			        		;
		        		
		        		
		        		
			        		Chang-Sup LIM
			        		
			        		;
		        		
		        		
		        		
			        		Hongbeom KIM
			        		
			        		;
		        		
		        		
		        		
			        		Jin-Young JANG
			        		
			        		;
		        		
		        		
		        		
			        		Sang Hyun SHIN
			        		
			        		;
		        		
		        		
		        		
			        		Jin Seok HEO
			        		
			        		;
		        		
		        		
		        		
			        		In Woong HAN
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:ORIGINAL ARTICLE
 
        	
        	
            
            
            	- From:Annals of Surgical Treatment and Research
	            		
	            		 2022;102(3):147-152
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	 Purpose:Postoperative pancreatic fistula (POPF) is a life-threatening complication following pancreatoduodenectomy (PD).We previously developed nomogram- and artificial intelligence (AI)-based risk prediction platforms for POPF after PD. This study aims to externally validate these platforms. 
				        	
				        
				        	Methods:Between January 2007 and December 2016, a total of 1,576 patients who underwent PD in Seoul National University Hospital, Ilsan Paik Hospital, and Boramae Medical Center were retrospectively reviewed. The individual risk scores for POPF were calculated using each platform by Samsung Medical Center. The predictive ability was evaluated using a receiver operating characteristic curve and the area under the curve (AUC). The optimal predictive value was obtained via backward elimination in accordance with the results from the AI development process. 
				        	
				        
				        	Results:The AUC of the nomogram after external validation was 0.679 (P < 0.001). The values of AUC after backward elimination in the AI model varied from 0.585 to 0.672. A total of 13 risk factors represented the maximal AUC of 0.672 (P < 0.001). 
				        	
				        
				        	Conclusion:We performed external validation of previously developed platforms for predicting POPF. Further research is needed to investigate other potential risk factors and thereby improve the predictability of the platform.