Establishing and clinically validating a machine learning model for predicting unplanned reoperation risk in colorectal cancer

Figure 1 Sample screening flow chart.

Figure 2 Comparative analysis of model performance and complexity across feature selection and regularization techniques. A: Training performance vs model complexity; B: Error rate vs number of features; C: Lasso model selection via cross-validation.

Figure 3 Signature variables of unplanned reoperation screened by machine learning. A: Extreme gradient boosting filtered unplanned reoperation feature variable; B: Supported vector machine filtered unplanned reoperation feature variable; C: Lasso filtered unplanned reoperation feature variable; D: Feature variables common to all three learning models Venn plot. TNM: Tumor-node-metastasis; BMI: Body mass index; ASA: American Society of Anesthesiologists; PNI: Prognostic nutritional index; SVM: Supported vector machine.

Figure 4 Nomogram of postoperative unplanned reoperation in colorectal cancer. PNI: Prognostic nutritional index.

Figure 5 Evaluation and validation of nomogram. A: Receiver operating characteristic curve of postoperative unplanned reoperation in colorectal cancer; B: Calibration curve of postoperative unplanned reoperation in colorectal cancer; C: Decision curve analysis curve of postoperative unplanned reoperation in colorectal cancer.

Figure 6 Calculation of risk score for training group and validation group patients. A: Calculation of patient risk score for training group; B: Calculation of patient risk score for validation group. ^aP < 0.001.

Figure 7 Receiver operating characteristic curve of training group and validation group patient risk scores in predicting patient reoperation. A and B: Receiver operating characteristic curve of risk score in predicting patient reoperation for (A) training group patients and (B) validation group patients.

Figure 8 Clinical validation of predictive modeling. The green dashed line is the patient total score and incidence probability marker, and the light orange arrow is the patient risk factor marker. PNI: Prognostic nutritional index.