title: Predicting postoperative vomiting among orthopedic patients receiving patient-controlled epidural analgesia using SVM and LR.
abstract: Patient-controlled epidural analgesia (PCEA) has been applied to reduce postoperative pain in orthopedic surgical patients. Unfortunately, PCEA is occasionally accompanied by nausea and vomiting. The logistic regression (LR) model is widely used to predict vomiting, and recently support vector machines (SVM), a supervised machine learning method, has been used for classification and prediction. Unlike our previous work which compared Artificial Neural Networks (ANNs) with LR, this study uses a SVM-based predictive model to identify patients with high risk of vomiting during PCEA and comparing results with those derived from the LR-based model. From January to March 2007, data from 195 patients undergoing PCEA following orthopedic surgery were applied to develop two predictive models. 75% of the data were randomly selected for training, while the remainder was used for testing to validate predictive performance. The area under curve (AUC) was measured using the Receiver Operating Characteristic curve (ROC). The area under ROC curves of LR and SVM models were 0.734 and 0.929, respectively. A computer-based predictive model can be used to identify those who are at high risk for vomiting after PCEA, allowing for patient-specific therapeutic intervention or the use of alternative analgesic methods.
authors.affiliation: Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University (No. 291, Zhongzheng Rd., Zhonghe, Taipei 23561,Taiwan.|Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hsin-Yun
authors.initials: HY
authors.lastname: Wu
authors.affiliation: Department of Electrical Engineering, Chang Gung University, Taoyuan County 33302, Taiwan.|Portable Energy System Group, Green Technology Research Center, College of Engineering, Chang Gung University, Taoyuan County 33302, Taiwan.|Chang Gung Memorial Hospital, Taoyuan 33304, Taiwan.
authors.forename: Cihun-Siyong Alex
authors.initials: CA
authors.lastname: Gong
authors.affiliation: Portable Energy System Group, Green Technology Research Center, College of Engineering, Chang Gung University, Taoyuan County 33302, Taiwan.
authors.forename: Shih-Pin
authors.initials: SP
authors.lastname: Lin
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, 11217, Taiwan.
authors.forename: Kuang-Yi
authors.initials: KY
authors.lastname: Chang
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, 11217, Taiwan.
authors.forename: Mei-Yung
authors.initials: MY
authors.lastname: Tsou
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, 11217, Taiwan.
authors.forename: Chien-Kun
authors.initials: CK
authors.lastname: Ting
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural / Q000379:methods*; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000779:Anesthetics, Local; D019540:Area Under Curve; D002045:Bupivacaine; D005260:Female; D005283:Fentanyl; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000175:diagnosis* / Q000517:prevention & control; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D060388:Support Vector Machine
chemical_list: D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine