Time-Series Aware Metrics for the Evaluation of Intraoperative Electroencephalography-Based Ischemia Detection

Continuous intraoperative monitoring with electroencephalo2 graphy (EEG) is commonly used to detect cerebral ischemia in high-risk surgical procedures such as carotid endarterectomy. Machine learning (ML) models that detect ischemia in real time can form the basis of automated intraoperative EEG monitoring. In this study, we describe and compare two time-series aware precision and recall metrics to the classical precision and recall metrics for evaluating the performance of ML models that detect ischemia. We trained six ML models to detect ischemia in intraoperative EEG and evaluated them with the area under the precision-recall curve (AUPRC) using time-series aware and classical approaches to compute precision and recall. The Support Vector Classification (SVC) model performed the best on the time-series aware metrics, while the Light Gradient Boosting Machine (LGBM) model performed the best on the classical metrics. Visual inspection of the probability outputs of the models alongside the actual ischemic periods revealed that the time-series aware AUPRC selected a model more likely to predict ischemia onset in a timely fashion than the model selected by classical AUPRC.