Turkish Neurosurgery 2022 , Vol 32 , Num 3
An Early Warning System Using Machine Learning for the Detection of Intracranial Hematomas in the Emergency Trauma Setting
Aydin AYDOSELI1,Tugrul Cem UNAL1,Onur KARDES2,Ozge DOGUC3,Ilyas DOLAS1,Ali Ekrem ADIYAMAN1,Emircan ORTAHISAR1,Gokhan SILAHTAROGLU3,Yavuz ARAS1,Pulat Akin SABANCI1,Serra SENCER4,Altay SENCER1
1Istanbul University, Istanbul Faculty of Medicine, Department of Neurosurgery, Istanbul, Turkey
2Beykent University, Department of Computer Engineering, Istanbul, Turkey
3Istanbul Medipol University, Department of Management Information Systems, Istanbul, Turkey
4Istanbul University, Istanbul Faculty of Medicine, Department of Radiology, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.35996-21.1 AIM: To present an early warning system (EWS) that employs a supervised machine learning algorithm for the rapid detection of extra-axial hematomas (EAHs) in an emergency trauma setting.

MATERIAL and METHODS: A total of 150 sets of cranial computed tomography (CT) scans were used in this study with a total of 11,025 images. Of the CTs, 75 were labeled as EAH, the remaining 75 were normal. A random forest algorithm was utilized for the detection of EAHs. The CTs were randomized into two groups: 100 samples for training of the algorithm (split evenly between EAH and normal cases), and 50 samples for testing. In the training phase, the algorithm scanned every CT slice separately for image features such as entropy, moment, and variance. If the algorithm determined an EAH on two or more images in a CT set, then the workflow produced an alert in the form of an email.

RESULTS: Data from 50 patients (25 EAH and 25 controls) were used for testing the EWS. For all CTs with an EAH, an alert was produced, with a 0% false-negative rate. For 16% of the cases, the practitioner received an email from the EWS that the patient might have an EAH despite having a normal CT scan. Positive and negative predictive values were 86% and 100%, respectively.

CONCLUSION: An EWS based on a machine learning algorithm is an efficient and inexpensive way of facilitating the work of emergency practitioners such as emergency physicians, neuroradiologists, and neurosurgeons. Keywords : Artificial intelligence, Machine learning, Epidural hematoma, Subdural hematoma, Trauma

Corresponding author : Tugrul Cem UNAL, tugrulcem@gmail.com