{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:14:22Z","timestamp":1787004862190,"version":"build-2736575974"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Acute abdominal pain is a common presenting symptom in the emergency department and represents heterogeneous causes and diagnoses. There is often a decision to be made regarding emergency\n            surgical care. Machine learning (ML) could be used here as a decision-support and relieve the time and personnel resource shortage.<\/jats:p>\n                  <jats:p>Patients with acute abdominal pain presenting to the Department of Surgery at Bonn University Hospital in 2020 and 2021 were retrospectively analyzed. Clinical parameters as well as\n            laboratory values were used as predictors. After randomly splitting into a training and test data set (ratio 80 to 20), three ML algorithms were comparatively trained and validated. The\n            entire procedure was repeated 20 times.<\/jats:p>\n                  <jats:p>A total of 1357 patients were identified and included in the analysis, with one in five (n\u00a0=\u00a0276, 20.3%) requiring emergency abdominal surgery within 24 hours. Patients operated on were\n            more likely to be male (p\u00a0=\u00a00.026), older (p\u00a0=\u00a00.006), had more gastrointestinal symptoms (nausea: p\u00a0&lt;\u00a00.001, vomiting p\u00a0&lt;\u00a00.001) as well as a more recent onset of pain\n            (p\u00a0&lt;\u00a00.001). Tenderness (p\u00a0&lt;\u00a00.001) and guarding (p\u00a0&lt;\u00a00.001) were more common in surgically treated patients and blood analyses showed increased inflammation levels (white blood\n            cell count: p\u00a0&lt;\u00a00.001, CRP: p\u00a0&lt;\u00a00.001) and onset of organ dysfunction (creatinine: p\u00a0&lt;\u00a00.014, quick p\u00a0&lt;\u00a00.001). Of the three trained algorithms, the tree-based methods (h2o\n            random forest and cforest) showed the best performance. The algorithms classified patients, i.e., predicted surgery, with a median AUC ROC of 0.81 and 0.79 and AUC PRC of 0.56 in test\n            sets.<\/jats:p>\n                  <jats:p>A proof-of-concept was achieved with the development of an ML model for predicting timely surgical therapy for acute abdomen. The ML algorithm can be a valuable tool in decision-making.\n            Especially in the context of heavily used medical resources, the algorithm can help to use these scarce resources more effectively. Technological progress, especially regarding artificial\n            intelligence, increasingly enables evidence-based approaches in surgery but requires a strictly interdisciplinary approach. In the future, the use and handling of ML should be integrated\n            into surgical training.<\/jats:p>","DOI":"10.1055\/a-2125-1559","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T18:30:26Z","timestamp":1691692226000},"page":"376-383","source":"Crossref","is-referenced-by-count":6,"title":["Machine Learning for Decision-Support in Acute Abdominal Pain \u2013 Proof of Concept and Central Considerations"],"prefix":"10.1055","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6608-8381","authenticated-orcid":false,"given":"Jonas","family":"Henn","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Hatterscheidt","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0305-6283","authenticated-orcid":false,"given":"Anshupa","family":"Sahu","sequence":"additional","affiliation":[{"name":"Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany"},{"name":"Institute for Genomic Statistics and Bioinformatics, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Buness","sequence":"additional","affiliation":[{"name":"Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany"},{"name":"Institute for Genomic Statistics and Bioinformatics, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6907-3844","authenticated-orcid":false,"given":"Jonas","family":"Dohmen","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0705-2973","authenticated-orcid":false,"given":"Jan","family":"Arensmeyer","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Feodorovici","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Sommer","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany"},{"name":"Department of Thoracic Surgery, Helios Hospital Bonn Rhein-Sieg, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg C.","family":"Kalff","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanno","family":"Matthaei","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,8,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/S0733-8627(02)00080-9","article-title":"Pearls and pitfalls in the emergency department evaluation of abdominal pain","volume":"21","author":"RA Kamin","year":"2003","journal-title":"Emerg Med Clin North Am"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1159\/000371583","article-title":"Guideline for the Diagnostic Pathway in Patients with Acute Abdominal Pain","volume":"32","author":"SL Gans","year":"2015","journal-title":"Dig 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