{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T11:00:29Z","timestamp":1784977229304,"version":"3.55.0"},"reference-count":21,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004390","name":"ottawa hospital","doi-asserted-by":"publisher","award":["Grant # TOH 15-001; Grant # TOH-21-20"],"award-info":[{"award-number":["Grant # TOH 15-001; Grant # TOH-21-20"]}],"id":[{"id":"10.13039\/501100004390","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations&amp;#65533;(Phila)"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study evaluates the performance of an artificial intelligence predictive clinical decision support system (CheLSEA) in generating chest tube management recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>From October 2020 to May 2021, 50 adult elective pulmonary resection patients with at least 24 h of chest tube drainage were enrolled in a single-arm, double-anonymized, observational study to evaluate CheLSEA\u2019s performance compared with standard chest tube care. Clinical status, digital pleural drainage data, and chest X-ray data were collected prospectively. For each query, CheLSEA generated a recommendation for chest tube removal or maintenance. If maintenance was recommended, CheLSEA generated a removal time prediction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Most patients were female (29 of 47, 62%), smokers (39 of 47, 83%), with a median age of 73 (interquartile range [IQR]: 66 to 77) years, who underwent minimally invasive (44 of 47, 94%) lobectomy (41 of 47, 87%) for primary non-small cell lung cancer (35 of 47, 75%). CheLSEA was queried 174 times, 21% (36 of 174) of which triggered the CheLSEA safeguard system, mostly due to grade 3 or increasing subcutaneous emphysema (20 of 36, 56%). CheLSEA recommended chest tube removal in 9% of remaining requests (12 of 138), 83% of which were safe (10 of 12) and 17% of which were premature by \u22646 h (2 of 12). The remaining 126 queries were answered with chest tube maintenance recommendations up to the optimal removal time (97 of 126, 77%) or shortly thereafter (29 of 126, 23%; median = 17 h, IQR: 17 to 22). When predicting chest tube removal time, 93% of responses (82 of 88) were accurate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>CheLSEA provides safe chest tube management recommendations and can potentially enhance care by reliably emulating expert-level clinical guidance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15569845261425605","type":"journal-article","created":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T04:23:12Z","timestamp":1776486192000},"page":"166-172","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Chest Tube Learning Synthesis and Evaluation Assistant (CheLSEA): A Prospective Observational Trial of an Intelligent Decision Support System"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3509-3940","authenticated-orcid":false,"given":"Nikita","family":"Arora","sequence":"first","affiliation":[{"name":"Division of Thoracic Surgery, The Ottawa Hospital, ON, Canada"},{"name":"Faculty of Medicine, University of Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9616-8662","authenticated-orcid":false,"given":"William","family":"Klement","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, The Ottawa Hospital, ON, Canada"},{"name":"The Ottawa Hospital Research Institute, ON, Canada"},{"name":"Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Japkowicz","sequence":"additional","affiliation":[{"name":"American University, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel G.","family":"Jones","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, The Ottawa Hospital, ON, Canada"},{"name":"Faculty of Medicine, University of Ottawa, ON, Canada"},{"name":"The Ottawa Hospital Research Institute, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna E.","family":"Maziak","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, The Ottawa Hospital, ON, Canada"},{"name":"Faculty of Medicine, University of Ottawa, ON, Canada"},{"name":"The Ottawa Hospital Research Institute, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.E.","family":"Seely","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, The Ottawa Hospital, ON, Canada"},{"name":"Faculty of Medicine, University of Ottawa, ON, Canada"},{"name":"The Ottawa Hospital Research Institute, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6970-1233","authenticated-orcid":false,"given":"Sudhir R.","family":"Sundaresan","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, The Ottawa Hospital, ON, Canada"},{"name":"Faculty of Medicine, University of Ottawa, ON, Canada"},{"name":"The Ottawa Hospital Research Institute, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"Villeneuve","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, The Ottawa Hospital, ON, Canada"},{"name":"Faculty of Medicine, University of Ottawa, ON, Canada"},{"name":"The Ottawa Hospital Research Institute, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, The Ottawa Hospital, ON, Canada"},{"name":"Faculty of Medicine, University of Ottawa, ON, Canada"},{"name":"The Ottawa Hospital Research Institute, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1109\/DSAA.2019.00058"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.10.122"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.07.055"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s41060-021-00296-8"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.21037\/ccts-22-11"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.08.11"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-019-0548-6"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.03.043"},{"key":"e_1_3_3_10_2","article-title":"Optimizing postoperative care protocols in thoracic surgery: best evidence and new technology","volume":"8","author":"French DG","year":"2016","unstructured":"French DG, Dilena M, LaPlante S, et al. Optimizing postoperative care protocols in thoracic surgery: best evidence and new technology. J Thorac Dis 2016; 8(suppl 1): S3\u2013S11.","journal-title":"J Thorac Dis"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2015.08.051"},{"key":"e_1_3_3_12_2","first-page":"1719","article-title":"Digital versus traditional air leak evaluation after elective pulmonary resection: a prospective and comparative mono-institutional study","volume":"7","author":"Filosso PL","year":"2015","unstructured":"Filosso PL, Nigra VA, Lanza G, et al. Digital versus traditional air leak evaluation after elective pulmonary resection: a prospective and comparative mono-institutional study. J Thorac Dis 2015; 7: 1719\u20131724.","journal-title":"J Thorac Dis"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivv128"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2010.07.025"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu470"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.05.150"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.05.069"},{"key":"e_1_3_3_18_2","unstructured":"Gilbert S and French DG. Closed pleural drainage and suction systems: Pearson\u2019s general thoracic STS cardiothoracic surgery e-book https:\/\/ebook.sts.org\/sts\/view\/Pearsons-General-Thoracic\/1418431\/6\/Closed_Pleural_Drainage_and_Suction_Systems?refer=true (2024 accessed 21 March 2025)."},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.11.99"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjae.2023.04.003"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-21-761"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezae013"}],"container-title":["Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845261425605","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15569845261425605","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845261425605","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T10:08:02Z","timestamp":1784974082000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15569845261425605"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1177\/15569845261425605"],"URL":"https:\/\/doi.org\/10.1177\/15569845261425605","relation":{},"ISSN":["1556-9845","1559-0879"],"issn-type":[{"value":"1556-9845","type":"print"},{"value":"1559-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}