Efficacy of machine learning to identify clinical factors influencing levothyroxine dosage after total thyroidectomy. 

 -  2022 
<br/><br/> BACKGROUND: We employed Machine Learning (ML) to evaluate potential additional clinical factors influencing replacement dosage requirements of levothyroxine.  CONCLUSIONS: Along with weight, sex, age, and BMI, ML algorithms indicated that race, ethnicity, lifestyle and comorbidity factors also may impact levothyroxine dosing in post-thyroidectomy patients with benign conditions. Copyright © 2022 Elsevier Inc. All rights reserved.  METHOD: This was a retrospective study of patients who underwent total or completion thyroidectomy with benign pathology. Patients who achieved an euthyroid state were included in three different ML models.  RESULTS: Of the 487 patients included, mean age was 54.1 +/- 14.1 years, 86.0% were females, 39.0% were White, 53.0% Black, 2.7% Hispanic, 1.4% Asian, and 3.9% Other. The Extreme Gradient Boosting (XGBoost) model achieved the highest accuracy at 61.0% in predicting adequate dosage compared to 47.0% based on 1.6 mcg/kg/day (p < 0.05). The Poisson regression indicated non-Caucasian race (p < 0.05), routine alcohol use (estimate = 0.03, p = 0.02), and osteoarthritis (estimate = -0.10, p < 0.001) in addition to known factors such as age (estimate = -0.003, p < 0.001), sex (female, estimate = -0.06, p < 0.001), and weight (estimate = 0.01, p < 0.001) were associated with the dosing of levothyroxine. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>0002-9610 
<br/><br/><label>Standard No.: </label>10.1016/j.amjsurg.2022.11.025 [doi] S0002-9610(22)00735-8 [pii] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>IN PROCESS -- NOT YET INDEXED
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Health Research Institute<br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>Medicine/Endocrinology<br/>MedStar General Surgery Residency<br/>MedStar Georgetown University Hospital/MedStar Washington Hospital Center<br/>Surgery/Endocrine Surgery
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article