{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T06:29:40Z","timestamp":1764052180935,"version":"3.45.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Artif. Intell."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post-operative ileus (POI) is a frequent complication after radical cystectomy (RC). Conventional scores capture only linear relations and have limited accuracy. Interpretable machine learning (ML) may improve early risk stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In a single-centre real-world cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f1,062, 2013\u20132023), POI was defined by \u22652 standard clinical\u2013radiological criteria. We extracted pre-operative comorbidities\/medications, operative factors (approach, urinary diversion, lymph-node dissection, fluids, blood loss, nasogastric-tube placement) and first-day laboratory indices. After LASSO selection, five ML models were trained\/validated on a stratified split; discrimination (AUC), accuracy, precision, recall and Brier score were compared. SHAP delivered global and patient-level explanations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>POI occurred in 28.9%. The back-propagation neural network performed best (AUC 0.828; accuracy 78.4%; Brier 0.143). Intra-operative nasogastric-tube placement and surgical approach dominated feature attribution, followed by medication history, lymph-node dissection, lymphocyte count and C-reactive protein. SHAP clarified feature effects and enabled interpretable, case-level risk summaries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An interpretable ML model based on routinely captured peri-operative variables accurately stratifies RC patients at risk for POI as early as postoperative day 0, outperforming existing nomograms and highlighting modifiable factors. Embedding this tool into electronic-health-record workflows could enable real-time alerts and risk-adapted management. Prospective multicentre validation is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frai.2025.1678292","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T06:24:55Z","timestamp":1764051895000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Explainable machine learning to predict postoperative ileus after radical cystectomy: an 11-year real-world cohort"],"prefix":"10.3389","volume":"8","author":[{"given":"Xiaoping","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guolong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zongxin","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiming","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuyi","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Man","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengxiao","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1016\/j.clnu.2015.01.016","article-title":"Postoperative ileus: recent developments in pathophysiology and management","volume":"34","author":"Bragg","year":"2015","journal-title":"Clin. 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