Artificial neural networks for decision-making in urologic oncology

Artificial neural networks (ANNs) are computational methodologies that perform multifactorial analyses, inspired by networks of biological neurons. Like neural networks, ANNs contain layers of simple points (nodes) of data that interract through carefully weighted connection lines. ANNs are "trained" and balanced by having been previously fed data, which the ANN uses as the means for adjusting its interconnections. Studies have shown that novel and highly accurate ANNs significantly enhance the ability to detect prostate cancer early (high sensitivity) while avoiding a greater number of unnecessary tissue samplings (high specificity). The use of ANNs in prostate cancer is ideal because of 1) multiple predicting factors that influence outcome; 2) the desire to offer individual consulting based on various tests; 3) the fact that prior logistic regression analysis results have had serious limitations in application; and 4) the need for an up-to-date tool that can apply easily to everyone. An ANN should be seen as an important tool that is complementary to the physician's personal knowledge and judgment in making decisions.