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This study aimed to develop a machine learning (ML) model to predict this reoperation risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was conducted according to TRIPOD\u2009+\u2009AI. Data from the PARITY trial was used to develop ML models to predict the 1\u2010year reoperation risk following lower extremity oncological resection and reconstruction. Six ML algorithms were tuned and calibrated based on fivefold cross\u2010validation. The best\u2010performing model was identified using classification and calibration metrics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The polynomial support vector machine (SVM) model was chosen as the best\u2010performing model. During internal validation, the SVM exhibited an AUC\u2010ROC of 0.73 and a Brier score of 0.17. Using an optimal threshold that balances all quadrants of the confusion matrix, the SVM exhibited a sensitivity of 0.45 and a specificity of 0.81. Using a high\u2010sensitivity threshold, the SVM exhibited a sensitivity of 0.68 and a specificity of 0.68. Total operative time was the most important feature for reoperation risk prediction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The models may facilitate reoperation risk stratification, allowing for better patient counseling and for physicians to implement measures that reduce surgical risks.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27854","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T07:19:12Z","timestamp":1726039152000},"page":"1706-1716","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Development of Machine Learning Models for Predicting the 1\u2010Year Risk of Reoperation After Lower Limb Oncological Resection and Endoprosthetic Reconstruction Based on Data From the PARITY Trial"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8274-6468","authenticated-orcid":false,"given":"Jiawen","family":"Deng","sequence":"first","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myron","family":"Moskalyk","sequence":"additional","affiliation":[{"name":"Biostatistics Division, Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Shammas\u2010Toma","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Aoude","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery McGill University Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Ghert","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery McMaster University Hamilton Ontario Canada"},{"name":"Department of Orthopaedics, University of Maryland School of Medicine University of Maryland Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahir","family":"Bhatnagar","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics McGill University Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8195-2086","authenticated-orcid":false,"given":"Anthony","family":"Bozzo","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery McGill University Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(03)01114-8"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2013.00210"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199405000-00004"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(99)90161-2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10434-004-1171-3"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-008-0386-2"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00834"},{"key":"e_1_2_10_9_1","first-page":"65","article-title":"Operative Treatment and Outcomes of Pediatric Patients with an Extremity Bone Tumor: A Secondary Analysis of the PARITY Trial Data","volume":"105","author":"Bozzo A.","year":"2023","journal-title":"Journal of Bone and Joint Surgery. 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