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Med."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Fine-grained analysis of intraoperative behavior and its impact on patient outcomes remains a longstanding challenge. We present Frame-to-Outcome (F2O), an end-to-end system that translates tissue dissection videos into gesture sequences and uncovers patterns associated with postoperative outcomes. Leveraging transformer-based spatial and temporal modeling and frame-wise classification, F2O robustly detects consecutive short (\u02dc2\u2009s) gestures in the nerve-sparing step of robot-assisted radical prostatectomy (AUC: 0.80 frame-level; 0.81 video-level). F2O-derived features\u2014gesture frequency, duration, and transitions\u2014predicted postoperative outcomes with accuracy comparable to human annotations (0.79 vs. 0.75; overlapping 95% CI). Across 25 shared features, effect size directions were concordant with small differences (\n                    <jats:bold>\u2206<\/jats:bold>\n                    <jats:italic>d<\/jats:italic>\n                    <jats:sub>avg<\/jats:sub>\n                    \u2009\u2248\u2009\n                    <jats:bold>0<\/jats:bold>\n                    .\n                    <jats:bold>07<\/jats:bold>\n                    ), and strong correlation (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u2009\n                    <jats:bold>0<\/jats:bold>\n                    .\n                    <jats:bold>96<\/jats:bold>\n                    ,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009\n                    <jats:bold>1<\/jats:bold>\n                    \u2009\n                    <jats:italic>\u00d7<\/jats:italic>\n                    \u2009\n                    <jats:bold>10<\/jats:bold>\n                    <jats:sup>\n                      <jats:italic>\u2212<\/jats:italic>\n                      <jats:bold>14<\/jats:bold>\n                    <\/jats:sup>\n                    ). F2O also captured key patterns linked to erectile function recovery, including prolonged tissue peeling and reduced energy use. By enabling automatic interpretable assessment, F2O establishes a foundation for data-driven surgical feedback and prospective clinical decision support.\n                  <\/jats:p>","DOI":"10.1038\/s41746-026-02927-5","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T07:35:07Z","timestamp":1782200107000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["End to end AI system for surgical gesture sequence recognition and clinical outcome prediction"],"prefix":"10.1038","volume":"9","author":[{"given":"Xi","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ujjwal","family":"Pasupulety","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atharva","family":"Deo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherine","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Moran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel E.","family":"Hernandez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Wager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanine","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvin C.","family":"Goh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey A.","family":"Sonn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"2927_CR1","doi-asserted-by":"crossref","unstructured":"Levendovics, R., Levendovics, T., Kronreif, G. & Haidegger, T. 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