title: Artificial neural network model for predicting 5-year mortality after surgery for hepatocellular carcinoma: a nationwide study.
abstract: BACKGROUND
  To validate the use of artificial neural network (ANN) models for predicting 5-year mortality in HCC and to compare their predictive capability with that of logistic regression (LR) models.
  
  
  METHODS
  This study retrospectively compared LR and ANN models based on initial clinical data for 22,926 HCC surgery patients from 1998 to 2009. A global sensitivity analysis was also performed to assess the relative significance of input parameters in the system model and to rank the importance of variables.
  
  
  RESULTS
  Compared to the LR models, the ANN models had a better accuracy rate in 96.57 % of cases, a better Hosmer-Lemeshow statistic in 0.34 of cases, and a better receiver operating characteristic curves in 88.51 % of cases. Surgeon volume was the most influential (sensitive) parameter affecting 5-year mortality followed by hospital volume and Charlson co-morbidity index.
  
  
  CONCLUSIONS
  In comparison with the conventional LR model, the ANN model in this study was more accurate in predicting 5-year mortality. Further studies of this model may consider the effect of a more detailed database that includes complications and clinical examination findings as well as more detailed outcome data.
authors.affiliation: Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Hon-Yi
authors.initials: HY
authors.lastname: Shi
authors.forename: King-Teh
authors.initials: KT
authors.lastname: Lee
authors.forename: Jhi-Joung
authors.initials: JJ
authors.lastname: Wang
authors.forename: Ding-Ping
authors.initials: DP
authors.lastname: Sun
authors.forename: Hao-Hsien
authors.initials: HH
authors.lastname: Lee
authors.forename: Chong-Chi
authors.initials: CC
authors.lastname: Chiu
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016571:Neural Networks, Computer; D012372:ROC Curve