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Right population, right resources, right algorithm: Using machine learning efficiently and effectively in surgical

Lauren Eyler Dang1, Alan Hubbard2, Fanny Nadia Dissak-Delon3

  • 1University of California, Berkeley, School of Public Health, Division of Biostatistics, Berkeley, CA; University of California, San Francisco, Department of Surgery, San Francisco, CA.

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Summary

Developing machine learning models for healthcare in low-resource settings requires careful consideration of the target population, available data, and appropriate algorithms. Open-source tools can help adapt these models globally for better surgical care and public health.

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Area of Science:

  • Medical Informatics
  • Public Health
  • Machine Learning

Background:

  • Machine learning (ML) shows promise for improving surgical care, diagnostics, and public health surveillance in low- and middle-income countries (LMICs).
  • Developing and implementing ML models in LMICs faces challenges due to limited data availability and resources.

Purpose of the Study:

  • To share practical lessons for developing context-appropriate and resource-conscious ML models for healthcare in LMICs.
  • To guide researchers in overcoming data limitations and optimizing algorithm development.

Main Methods:

  • Reviewing experiences and literature on ML model development in resource-limited settings.
  • Highlighting strategies for cohort selection, data integration, and algorithm choice (e.g., Super Learner ensemble).

Main Results:

  • Training cohorts should mirror the target population; recalibration aids model transportability.
  • Algorithms should leverage existing or easily obtainable data for seamless clinical integration.
  • The Super Learner algorithm can optimize model selection and minimize bias.

Conclusions:

  • Context-appropriate and resource-conscious ML models are achievable by considering population, resources, and algorithms.
  • Open-source code, apps, and training materials are crucial for adapting ML models globally.
  • Addressing data gaps and computational limitations will further advance ML in LMIC healthcare.