Machine learning in neurosurgery: a global survey

Acta Neurochirurgica, vol. 162, pp. 3081–3091

Abstract

BACKGROUND: Recent technological advances have led to the development and implementation of machine learning (ML) in various disciplines, including neurosurgery. Our goal was to conduct a comprehensive survey of neurosurgeons to assess the acceptance of and attitudes toward ML in neurosurgical practice and to identify factors associated with its use. METHODS: The online survey consisted of nine or ten mandatory questions and was distributed in February and March 2019 through the European Association of Neurosurgical Societies (EANS) and the Congress of Neurosurgeons (CNS). RESULTS: Out of 7280 neurosurgeons who received the survey, we received 362 responses, with a response rate of 5%, mainly in Europe and North America. In total, 103 neurosurgeons (28.5%) reported using ML in their clinical practice, and 31.1% in research. Adoption rates of ML were relatively evenly distributed, with 25.6% for North America, 30.9% for Europe, 33.3% for Latin America and the Middle East, 44.4% for Asia and Pacific and 100% for Africa with only two responses. No predictors of clinical ML use were identified, although academic settings and subspecialties neuro-oncology, functional, trauma and epilepsy predicted use of ML in research. The most common applications were for predicting outcomes and complications, as well as interpretation of imaging. CONCLUSIONS: This report provides a global overview of the neurosurgical applications of ML. A relevant proportion of the surveyed neurosurgeons reported clinical experience with ML algorithms. Future studies should aim to clarify the role and potential benefits of ML in neurosurgery and to reconcile these potential advantages with bioethical considerations.

Authors 11

1. Victor E. Staartjes corresponding

   University of Zurich · University Hospital Zurich · Bergman Clinics · Amsterdam University Medical Centers · Amsterdam Movement Sciences · Vrije Universiteit Amsterdam

   Affiliation as printed

   Amsterdam UMC, Vrije Universiteit Amsterdam, Neurosurgery, Amsterdam Movement Sciences, Amsterdam, The Netherlands. victor.staartjes@gmail.com

   Department of Neurosurgery, Bergman Clinics, Amsterdam, The Netherlands. victor.staartjes@gmail.com

   Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland. victor.staartjes@gmail.com

   Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland

2. Vittorio Stumpo

   Università Cattolica del Sacro Cuore · University of Zurich · University Hospital Zurich

   Affiliation as printed

   Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland

   Università Cattolica del Sacro Cuore, Rome, Italy

3. Julius M. Kernbach Aachen Department of Neurosurgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Neurosurgery, RWTH Aachen University Hospital, Aachen, Germany

4. Anita Maria Klukowska

   University of Nottingham · Bergman Clinics

   Affiliation as printed

   Department of Neurosurgery, Bergman Clinics, Amsterdam, The Netherlands

   School of Medicine, University of Nottingham, Nottingham, UK

5. Pravesh Shankar Gadjradj Aachen Department of Neurosurgery, Leiden University Medical Centre

   Leiden University · Leiden University Medical Center · Erasmus MC

   Affiliation as printed

   Department of Neurosurgery, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands

   Department of Neurosurgery, Leiden University Medical Centre, Leiden, The Netherlands

6. Marc L. Schröder

   Bergman Clinics

   Affiliation as printed

   Department of Neurosurgery, Bergman Clinics, Amsterdam, The Netherlands

7. Anand Veeravagu

   Stanford Medicine · Stanford University

   Affiliation as printed

   Neurosurgery AI Lab, Department of Neurosurgery, Stanford University, Stanford, CA, USA

8. Martin Nikolaus Stienen

   University of Zurich · University Hospital Zurich

   Affiliation as printed

   Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland

9. Christiaan Hendrik Bas van Niftrik

   University of Zurich · University Hospital Zurich

   Affiliation as printed

   Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland

10. Carlo Serra

    University of Zurich · University Hospital Zurich

    Affiliation as printed

    Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland

11. Luca Regli

    University of Zurich · University Hospital Zurich

    Affiliation as printed

    Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland