Neurosurgery inpatient outcome prediction for discharge planning with deep learning and transfer learning.

INTRODUCTION
Deep learning may be able to assist with the prediction of neurosurgical inpatient outcomes. The aims of this study were to investigate deep learning and transfer learning in the prediction of several inpatient outcomes including timing of discharge and discharge destination.


METHOD
Data were collected on consecutive neurosurgical admissions from existing databases over a 15-month period. Following pre-processing artificial neural networks were applied to admission notes and ward round notes to predict four inpatient outcomes. Models were developed on the training dataset, before being tested on a hold-out test dataset and a validation dataset.


RESULTS
1341 individual admissions were included in the study. Using transfer learning and an artificial neural network an area under the receiver operator curve (AUC) of 0.81 and 0.80 on the derivation and validation datasets was able to be achieved for the prediction of discharge within the next 48 hours using daily ward round notes. This result is in comparison to an AUC of 0.71 and 0.68 using an artificial neural network without transfer learning for the same outcome. When the artificial neural network with transfer learning was applied to the other outcomes AUC of 0.72, 0.93 and 0.83 was achieved on the validation datasets for predicting discharge within the next 7 days, survival to discharge and discharge to home as a destination.


CONCLUSIONS
Deep learning may predict inpatient neurosurgery outcomes from free-text medical data. Recurrent predictions with ward round notes enable the use of information obtained throughout hospital admissions in these estimates.