Bayesian Scoring Systems for Military Pelvic and Perineal Blast Injuries: Is it Time to Take a New Approach?

Background: Various injury severity scores exist for trauma; it is known that they do not correlate accurately to military injuries. A promising anatomical scoring system for blast pelvic and perineal injury led to the development of an improved scoring system using machine-learning techniques.Metho...

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Publicado en:Military Medicine Vol. 181; pp. 127 - 132
Autores principales: Mossadegh, Somayyeh, Shan He, Parker, Paul, He, Shan
Formato: research Journal Article
Publicado: Oxford University Press / USA May2016 Supplement
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Oxford University Press / USA
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        atl: Bayesian Scoring Systems for Military Pelvic and Perineal Blast Injuries: Is it Time to Take a New Approach?
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          Mossadegh, Somayyeh
          Shan He
          Parker, Paul
          He, Shan
        affil: Queen Mary University of London, Blizard Institute, Barts and The London School of Medicine and Dentistry, The Blizard Building, 4 Newark Street, London El 2AT, United Kingdom.
      sug:
        subj:
          Probability
          Wounds and Injuries Classification
          Trauma Severity Indices
          Quality of Health Care
          Pelvis Injuries
          Adult
          Prospective Studies
          Perineum Physiopathology
          Blast Injuries Epidemiology
          Military Personnel Statistics and Numerical Data
          Pelvis Physiopathology
          Male
          Retrospective Design
          Data Collection
          Female
          Perineum Injuries
          Human
          Clinical Assessment Tools
          Adult: 19-44 years
          Male
          Female
      ab: Background: Various injury severity scores exist for trauma; it is known that they do not correlate accurately to military injuries. A promising anatomical scoring system for blast pelvic and perineal injury led to the development of an improved scoring system using machine-learning techniques.Methods: An unbiased genetic algorithm selected optimal anatomical and physiological parameters from 118 military cases. A Naïve Bayesian model was built using the proposed parameters to predict the probability of survival. Ten-fold cross validation was employed to evaluate its performance.Results: Our model significantly out-performed Injury Severity Score (ISS), Trauma ISS, New ISS, and the Revised Trauma Score in virtually all areas; positive predictive value 0.8941, specificity 0.9027, accuracy 0.9056, and area under curve 0.9059. A two-sample t test showed that the predictive performance of the proposed scoring system was significantly better than the other systems (p < 0.001).Conclusion: With limited resources and the simplest of Bayesian methodologies, we have demonstrated that the Naïve Bayesian model performed significantly better in virtually all areas assessed by current scoring systems used for trauma. This is encouraging and highlights that more can be done to improve trauma systems not only for our military injured, but also for civilian trauma victims.
      pubtype: Academic Journal
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        Journal Article
      ougenre: Article
    language: English
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