Table 5.
Summary of studies using electronic health records for predicting the need of glaucoma surgery
| Year | First author | Aim | Outcome | Dataset | Model | Input | Output | Results |
|---|---|---|---|---|---|---|---|---|
| 2019 | Baxter et al.[20] | Predict surgical progression | AUC, OR | 385 POAG subjects | MVLR, ANN, random forest | EHR | Surgical progression | MVLR: AUC: 0.67. Factors identified with higher and lower chances of surgery. Higher mean systolic BP increased odds surgery (OR=1.09, P<0.001). Ophthalmic medications (OR=0.28, P<0.001), nonopioid analgesic medications (OR=0.21, P=0.002), anti-hyperlipidaemic medications (OR=0.39, P=0.004), macrolide antibiotics (OR=0.40, P=0.03) and calcium blockers (OR=0.43, P=0.03) decreased odds of glaucoma surgery |
| 2021 | Baxter et al.[101] | Predict surgical progression | Accuracy, AUC | 1231 POAG subjects from all of us research program | MVLR, ANN, random forest | EHR | Surgical progression | Accuracy: 0.69, AUC: 0.49 with the original model. However better performance with retraining with new data, 0.80 (logistic regression) to 0.99 (random forests) |
| 2022 | Wang et al.[21] | Predict surgical progression | AUC, F1 | 748 underwent surgery, 4512 subjects | CNN[108] | EHR | Surgical progression | Structured clinical features + clinical notes: AUC 73%, F1: 40%, only clinical features: AUC 66%, F1: 34%, only notes: AUC 70%, F1 42% glaucoma specialist: F1: 29.5%. However clinical predictions highest specificity (0.90), accuracy (0.79), and PPV (0.34) |
| 2022 | Hu and Wang[103] | Predict surgical progression | AUROC | 4512 subjects over 12 years | BERT | EHR | Surgical progression | Original BERT model had the highest AUROC (73.4%; F1=45.0%), RoBERTa, with an AUROC of 72.4% (F1=44.7%), DistilBERT, with an AUROC of 70.2% (F1=42.5%); and BioBERT, with an AUROC of 70.1% (F1=41.7%). All models had higher F1 scores than an ophthalmologist’s review of clinical notes (F1=29.9%) |
AUC/AUROC: Area under the receiver operating characteristic curve, ANN=Artificial neural network, BERT=Bidirectional encoder representations from transformers, CNN=Convolutional neural network, EHR=Electronic health records, MVLR=Multivariable logistic regression, OR=Odds ratio, PPV=Positive predictive value, POAG=Primary open-angle glaucoma