Efficacy of machine learning to identify clinical factors influencing levothyroxine dosage after total thyroidectomy.
Citation: American Journal of Surgery. 2022 Nov 21PMID: 36464545Institution: MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment: Medicine/Endocrinology | MedStar General Surgery Residency | MedStar Georgetown University Hospital/MedStar Washington Hospital Center | Surgery/Endocrine SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2022ISSN:- 0002-9610
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 36464545 | Available | 36464545 |
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.
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