CS-553 INTELLIGENT DATA ANALYSISguvenir/courses/CS553/Presentations/Can_F_Koyuncu.pdfCS-553 INTELLIGENT DATA ANALYSIS Effects of Preoperative Conditions of Patients on Surgery Types

CS-553

INTELLIGENT DATA

ANALYSIS Effects of Preoperative Conditions of Patients on

Surgery Types and Techniques

By

Can Fahrettin KOYUNCU

Dr. Tayfun ÖZDEM

29.12.2011 1

OUTLINE

• INTRODUCTION

•AIM

•DATASET

•EXPERIMENTAL RESULTS

•CONCLUSION

•FUTURE PLANS

29.12.2011 2

INTRODUCTION

• THE MOST COMMON TYPES OF HEART

SURGERIES

• CORONERY ARTERY BYPASS GRAFTING

• VALVE OPERATIONS (Pulmoner, Mitral, Trikuspid, Aortic valves)

• THE TECHNIQUES OF HEART OPERATIONS

• OFF PUMP

• ON PUMP

• ON PUMP BEATING HEART (HYBRID)

29.12.2011 3

29.12.2011 4

(*) http://drsvenkatesan.wordpress.com/2008/11/06/why-is-lima-graft-superior-than-saphenous-venous-graft/

Coronery Artery Bypass Graft (*)

http://drsvenkatesan.wordpress.com/2008/11/06/why-is-lima-graft-superior-than-saphenous-venous-graft/

















29.12.2011 5

(*) http://www.nlm.nih.gov/medlineplus/ency/imagepages/9380.htm

The valves of the heart (*)

http://www.nlm.nih.gov/medlineplus/ency/imagepages/9380.htm

29.12.2011 6

(*) http://www.ustudy.in/node/5071

The model of Heart-Lung machine (Pump) (*)

http://www.ustudy.in/node/5071

AIM

Organize the dataset for further researches.

Examine the relationship between the surgery

technique and preoperative conditions.

Examine the relationship between the surgery type and

preoperative conditions.

Have an experience how to deal with huge datasets in

real-life.

29.12.2011 7

DATASET

855 features in total

Personal Information (50 features)

Identifying Information

Admission Information

Pre-operative Information (284 features)

Risk Factors (66 features)

Physical Examinations (40 features)

Angio and Echo measurements (83 features)

Preoperative Medication (95 features)

Operative Information (377 features)

Surgery Information (220 features)

Perfusion Information (157 features)

Post-Operative Information (139 features)

29.12.2011 8

DATASET

Operation Type (8901 instances)

CABG (7358 instances)

Valve (1163 instances)

CABG + Valve (380 instances)

Operation Technique (3534 instances)

Off-pump (339 instances)

On-pump (3181 instances)

On-pump beating heart (14 instances)

29.12.2011 9

DATA PREPARATION Feature Selection

43 features (Risk Factors)

27 features (Physical Examinations)

20 features (Angio and Echo Measurements)

30 features (Preoperative Medication)

2 features (Operative Information)

Operation Type («CABG, Valve»)

Operation Technique («On-Pump, Off-Pump»)

Recalculate missing values («BMI, Kategorik BMI»)

Convert the categorical and ordered features into binary

• KategorikBMI => KategorikBMI_1, KategorikBMI_2, KategorikBMI_3

Ignore the instances of «On-Pump Beating Heart»

(insufficent data)

29.12.2011 10

DATA ANALYSIS

4 preoperative subsections

Risk Factors

Physical Examinations

Angio and Echo measurements

Preoperative Medication

For each subsection; Compare frequent itemsets of each class found and analyse them.

(Apriori Algorithm)

Classify instances and analyse them. (Decision Tree)

29.12.2011 11

EXPERIMENTAL

RESULTS-1 ASSOCIATION ANALYSIS FOR OFF-PUMP & ON-PUMP

29.12.2011 12

Frequent Items (Risk Factors)

29.12.2011 13

Experimental results

(Risk Factors) OFF-PUMP (339 Instances)

ITEMSETS SUPPORT

{Anjina Pektoris = 2} 0.39

{BMI < 25} 0.33


{Hipertansiyon, Hiperlipidemi} 0.27

{Hiperlipidemi, MI} 0.23

{Ailede Kroner Arter} 0.23

{DM} 0.23

{Hipertansiyon, 25<=BMI<30} 0.23

{BMI >= 30} 0.22

{KOAH} 0.21

29.12.2011 14

ON-PUMP (3181 Instances)

ITEMSETS SUPPORT

{Anjine Pektoris = 2} 0.36

{MI} 0.33

{BMI < 25} 0.31


{DM} 0.27


{BMI >= 30} 0.25



(Risk Factors) OFF-PUMP(339 Instances)

ITEMSETS SUPPORT


{BMI < 25} 0.33





{DM} 0.23


{BMI >= 30} 0.22

{KOAH} 0.21

29.12.2011 15


ITEMSETS SUPPORT


{MI} 0.33

{BMI < 25} 0.31


{DM} 0.27


{BMI >= 30} 0.25



(Risk Factors) OFF-PUMP(339 Instances)

ITEMSETS SUPPORT


{BMI < 25} 0.33





{DM} 0.23


{BMI >= 30} 0.22

{KOAH} 0.21

29.12.2011 16


ITEMSETS SUPPORT


{MI} 0.33

{BMI < 25} 0.31


{DM} 0.27


{BMI >= 30} 0.25


Frequent Items (Physical Examinations)

29.12.2011 17


(Physical Examinations)

OFF-PUMP

ITEMSETS SUPPORT

{Femoral Arter Sağ - Sol, Popliteal Arter Sağ - Sol, Dorsalis Pedis Sağ, Tibialis Posterior Sağ - Sol,

Radialis Sağ } 0.52

{Femoral Arter Sağ - Sol, Popliteal Arter Sağ - Sol, Dorsalis Pedis Sol, Tibialis Posterior Sağ - Sol,

Radialis Sağ - Sol} 0.52

{Popliteal Arter Sağ - Sol, Dorsalis Pedis Sağ - Sol, Tibialis Posterior Sağ - Sol, Radialis Sağ - Sol} 0.51

29.12.2011 18

ON-PUMP

ITEMSETS SUPPORT



{Femoral Arter Sağ - Sol, Popliteal Arter Sağ - Sol, Dorsalis Pedis Sağ - Sol, Tibialis Posterior Sol,


{Femoral Arter Sağ – Sol, Popliteal Arter Sağ - Sol, Dorsalis Pedis Sağ - Sol, Tibialis Posterior Sağ,






(Physical Examinations)

OFF-PUMP

ITEMSETS SUPPORT


Radialis Sağ } 0.52




29.12.2011 19

ON-PUMP

ITEMSETS SUPPORT



{Femoral Arter Sağ - Sol, Popliteal Arter Sağ - Sol, Dorsalis Pedis Sağ - Sol, Tibialis Posterior Sol,


{Femoral Arter Sağ – Sol, Popliteal Arter Sağ - Sol, Dorsalis Pedis Sağ - Sol, Tibialis Posterior Sağ,





Frequent Items (Angio & EchoMeasurements)

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(Angio & Echo Measurements) OFF-PUMP

ITEMSETS SUPPORT

{Koroner Arter Sayısı = 1} 0.30

{Dominant Koroner Arter(Sağ), LAD (>50% darlık), Sağ Koroner Arter (>50% darlık)} 0.07

{Mitral Yetmezlik, LAD (>50% darlık)} 0.06

{Dominant Koroner Arter(Sağ), LAD (>50% darlık), Circumflex (>50% darlık)} 0.06

{Koroner Arter Sayısı = 3, LAD (>50% darlık), Circumflex (>50% darlık), Sağ Koroner Arter

(>50% darlık)} 0.06

{Mitral Yetmezlik, Dominant Koroner Arter (sağ)} 0.05

{LMCA} 0.05

{Mitral Yetmezlik, Sağ Koroner Arter (>50%darlık)} 0.05

{Dominant Koroner Arter(Sağ), Koroner Arter Sayısı = 2, LAD (>50% darlık)} 0.05

29.12.2011 21

ON-PUMP

ITEMSETS SUPPORT



{LMCA} 0.08

{Mitral Yetmezlik} 0.07

{Koroner Arter Sayısı = 3, LAD (>50% darlık), Circumflex (>50 % darlık), Sağ Koroner Arter

(>50% darlık)} 0.06

{Dominant Koroner Arter (Sağ), Circumflex (>50 % darlık)} 0.05

{Dominant Koroner Arter(Sağ), LAD (>50 % darlık), Sağ Koroner Arter (>50% darlık)} 0.05



ITEMSETS SUPPORT






(>50% darlık)} 0.06


{LMCA} 0.05



29.12.2011 22

ON-PUMP

ITEMSETS SUPPORT



{LMCA} 0.08



(>50% darlık)} 0.06





ITEMSETS SUPPORT






(>50% darlık)} 0.06


{LMCA} 0.05



29.12.2011 23

ON-PUMP

ITEMSETS SUPPORT



{LMCA} 0.08



(>50% darlık)} 0.06



Frequent Items (Preoperative Medication)

29.12.2011 24


(Preoperative Medication – Off Pump)

29.12.2011 25

Itemsets Support Itemsets Support

{IVNitrat48s} 0.21 {Antikoagulan, Lipid, BetaBlocker, ACEinh} 0.06

{Antikoagulan, Lipid, BetaBlocker, Nitrogliserin} 0.10 {Lipid, BetaBlocker, ACEinh, Nitrogliserin} 0.06

{Antiagregan, Kalsiyum} 0.10 {Inotrop} 0.05

{Antikoagulan, H2, Lipid, BetaBlocker} 0.09 {Bronkodilator} 0.05

{Antiagregan, Lipid, BetaBlocker, Nitrogliserin} 0.09 {Insulin, BetaBlocker} 0.05

{Antiagregan, Lipid, BetaBlocker, ACEinh} 0.07 {Antidiabetik, Lipid} 0.05

{BetaBlocker, Kalsiyum, Nitrogliserin} 0.07 {Diuretik, Nitrogliserin} 0.05

{Lipid, BetaBlocker, Kalsiyum} 0.07 {Diuretik, Antikoagulan, H2} 0.05

{Antiagregan, ACEinh, Nitrogliserin} 0.07 {Diuretik, Lipid, BetaBlocker} 0.05

{Diuretik, Antikoagulan, BetaBlocker} 0.06 {Antikoagulan, H2, ACEinh} 0.05

{Antiagregan, Antikoagulan, Lipid} 0.06


(Preoperative Medication – On Pump)

29.12.2011 26


{IVNitrat48s} 0.33 {Antiagregan, Kalsiyum} 0.06

{Antikoagulan, Lipid, BetaBlocker, Nitrogliserin} 0.11 {BetaBlocker, ACEinh, Nitrogliserin} 0.06

{Antiagregan, Lipid, BetaBlocker} 0.09 {Antidiabetik, BetaBlocker} 0.06

{Diuretik, BetaBlocker} 0.07 {Insulin} 0.05

{Antikoagulan, H2, Lipid, BetaBlocker} 0.07 {Diuretik, H2} 0.05

{Antikoagulan, H2, ACEinh} 0.07 {H2, Lipid, ACEinh} 0.05

{Antiagregan, BetaBlocker, Nitrogliserin} 0.06 {Lipid, ACEinh, Nitrogliserin} 0.05

{Antikoagulan, Lipid, BetaBlocker, ACEinh} 0.06 {Antiagregan, H2} 0.05

{Diuretik, Antikoagulan} 0.06 {Antidiabetik, Antikoagulan, Lipid} 0.05

{H2, BetaBlocker, ACEinh} 0.06 {Antiagregan, Antikoagulan} 0.05

{Antiagregan, BetaBlocker, ACEinh} 0.06


(Preoperative Medication – Off Pump)

29.12.2011 27


{IVNitrat48s} 0.21 {Antikoagulan, Lipid, BetaBlocker, ACEinh} 0.06

{Antikoagulan, Lipid, BetaBlocker, Nitrogliserin} 0.10 {Lipid, BetaBlocker, ACEinh, Nitrogliserin} 0.06

{Antiagregan, Kalsiyum} 0.10 {Inotrop} 0.05

{Antikoagulan, H2, Lipid, BetaBlocker} 0.09 {Bronkodilator} 0.05

{Antiagregan, Lipid, BetaBlocker, Nitrogliserin} 0.09 {Insulin, BetaBlocker} 0.05

{Antiagregan, Lipid, BetaBlocker, ACEinh} 0.07 {Antidiabetik, Lipid} 0.05

{BetaBlocker, Kalsiyum, Nitrogliserin} 0.07 {Diuretik, Nitrogliserin} 0.05

{Lipid, BetaBlocker, Kalsiyum} 0.07 {Diuretik, Antikoagulan, H2} 0.05

{Antiagregan, ACEinh, Nitrogliserin} 0.07 {Diuretik, Lipid, BetaBlocker} 0.05

{Diuretik, Antikoagulan, BetaBlocker} 0.06 {Antikoagulan, H2, ACEinh} 0.05

{Antiagregan, Antikoagulan, Lipid} 0.06



29.12.2011 28















29.12.2011 29













EXPERIMENTAL

RESULTS-2 ASSOCIATION ANALYSIS FOR CABG & VALVE OPERATIONS

29.12.2011 30


(Risk Factors – Operation Type)

29.12.2011 31

CABG Itemsets Supp Itemsets Supp Itemsets Supp

{25<=BMI< 30, AnjinaPektoris= 2} 0.20 {DM, Anjina Pektoris = 2} 0.12 {KOAH} 0.14

{25<=BMI<30, MI} 0.19 {Dispne} 0.11 {Hipertansiyon, Anjina Pektoris = 3} 0.14

{MI, Anjina Pektoris = 2} 0.18 {BMI<25, Anjina Pektoris = 2} 0.11 {DM, 25<=BMI<30} 0.13

{DM, Hipertansiyon} 0.17 {BMI<25, MI} 0.11 {Hiperlipidemi, BMI >= 30} 0.12

{25<=BMI<30, Ailede Kroner Arter} 0.16 {BMI<25, Hipertansiyon} 0.11

{Hipertansiyon, 25<=BMI<30, Hiperlipidemi} 0.11

{Hipertansiyon, BMI>=30} 0.15 {25<=BMI< 30,

Anjina Pektoris = 3} 0.11 {DM, Ailede Kroner Arter} 0.10

{DM, Hiperlipidemi} 0.15 {Hiperlipidemi,

Anjina Pektoris = 3} 0.11 {Hipertansiyon, Ailede Kroner Arter,

Hiperlipidemi} 0.10

{Ailede Kroner Arter, Anjina Pektoris = 2}

0.15 {BMI>=30, Anjina Pektoris = 2} 0.11 {Hipertansiyon, Hiperlipidemi, MI} 0.10

{Ailede Kroner Arter, MI} 0.15 {DM, MI} 0.11

{Anjina Pektoris = 1} 0.14 {Hipertansiyon, Hiperlipidemi,

Anjina Pektoris = 2} 0.11



29.12.2011 32

Valve


{Ailede Koroner Arter var} 0.19 {25<= BMI<30, Anjina Pektoris = 1} 0.14

{BMI<25, Dispne} 0.18 {Hipertansiyon, 25 <= BMI < 30} 0.12

{Anjina Pektoris = 2} 0.18 {Kojestif Kalp Yetmezliği} 0.12

{Dispne, Anjina Pektoris = 1} 0.18 {KOAH} 0.12

{Dispne, Hipertansiyon} 0.17 {Son Yıl A.H. Ilac Kullanma} 0.11

{Hiperlipidemi} 0.16 {Perkutan Koroner} 0.11

{Dispne, 25<=BMI<30} 0.15 {Hipertansiyon, Anjina Pektoris = 1} 0.11

{DM} 0.14 {Hipertansiyon, BMI >= 30} 0.10

{BMI<25, Anjina Pektoris = 1} 0.14 {Dispne, BMI >= 30} 0.10



29.12.2011 33












Hiperlipidemi} 0.10





Anjina Pektoris = 2} 0.11



29.12.2011 34

Valve













29.12.2011 35












Hiperlipidemi} 0.10





Anjina Pektoris = 2} 0.11 Hipertansiyon, Hiperlipidemi

Hipertansiyon, Hiperlipidemi





29.12.2011 36

Valve












(Angio & Echo Measurements – Operation Type) CABG

VALVE

29.12.2011 37

Itemsets Supp



{LMCA Hastalığı} 0.06

{Koroner Arter Sayısı = 3, LAD darlık, circumflex darlık, Sağ koroner arter darlık}

0.06

{Dominant Koroner Arter = Sağ, LAD darlık, Sağ Koroner Arter darlık}

0.05

{Dominant Koroner Arter = Sağ, LAD darlık, Circumflex darlık}

0.05

Itemsets Supp


{AortYetmezlik, MitralStenoz, MitralYetmezlik}

0.08

{MitralStenoz, MitralYetmezlik, TrikuspidYetmezlik}

0.08

{AortYetmezlik, Dominant Koroner Arter = Sağ}

0.07

{AortYetmezlik, MitralYetmezlik, TrikuspidYetmezlik}

0.07

{PulmonerHT,MitralYetmezlik} 0.07

{PulmonerHT,MitralStenoz} 0.06

{PulmonerHT,TrikuspidYetmezik} 0.06

{AortStenoz, AortYetmezlik,MitralYetmezlik}

0.06


{MitralYetmezlik, TrikuspidYetmezlik, Dominant Koroner Arter = Sağ}

0.05

{AortStenoz, AortYetmezlik, MitralStenoz} 0.05


(Angio & Echo Measurements – Operation Type) CABG

VALVE

29.12.2011 38

Itemsets Supp



{LMCA Hastalığı} 0.06

{Koroner Arter Sayısı = 3, LAD darlık, circumflex darlık, Sağ koroner arter darlık}

0.06

{Dominant Koroner Arter = Sağ, LAD darlık, Sağ Koroner Arter darlık}

0.05

{Dominant Koroner Arter = Sağ, LAD darlık, Circumflex darlık}

0.05

Itemsets Supp


{AortYetmezlik, MitralStenoz, MitralYetmezlik}

0.08

{MitralStenoz, MitralYetmezlik, TrikuspidYetmezlik}

0.08

{AortYetmezlik, Dominant Koroner Arter = Sağ}

0.07

{AortYetmezlik, MitralYetmezlik, TrikuspidYetmezlik}

0.07

{PulmonerHT,MitralYetmezlik} 0.07

{PulmonerHT,MitralStenoz} 0.06

{PulmonerHT,TrikuspidYetmezik} 0.06

{AortStenoz, AortYetmezlik,MitralYetmezlik}

0.06


{MitralYetmezlik, TrikuspidYetmezlik, Dominant Koroner Arter = Sağ}

0.05

{AortStenoz, AortYetmezlik, MitralStenoz} 0.05


(Preoperative Medication – Operation Type)

29.12.2011 39

CABG

Itemsets Supp Itemsets Supp

{IVNitrat48s} 0.14

{ACEinh, Kalsiyum} 0.06

{Diuretik} 0.08

{Lipid, Kalsiyum} 0.06

{H2,BetaBlocker} 0.08

{Antikoagulan, ACEinh} 0.06

{BetaBlocker,Kalsiyum} 0.08

{Antiagregan, BetaBlocker, ACEinh, Nitrogliserin} 0.06

{Antiagregan, Lipid, BetaBlocker, Nitrogliserin}

0.08 {Antiagregan,Lipid,BetaBlocker,ACEinh}

0.05

{Antiagregan, Kalsiyum, Nitrogliserin}

0.07 {Lipid,BetaBlocker,ACEinh, Nitrogliserin}

0.05

{Antikoagulan, Lipid, BetaBlocker, Nitrogliserin}

0.07

{Antikoagulan,H2} 0.06

{H2,Lipid} 0.06



29.12.2011 40

VALVE

Itemsets Supp Itemsets Supp Itemsets Supp

{Diuretik, Kalsiyum} 0.09 {Diuretik, Antikoagulan,

BetaBlocker} 0.06 {ACEinh,

Kalsiyum} 0.06

{Antiagregan, BetaBlocker}

0.09 {Antikoagulan, H2, BetaBlocker}

0.06 {H2,ACEinh}

0.06

{Nitrogliserin} 0.08

{Diuretik,Dijital,ACEinh} 0.06

{Diuretik, Lipid} 0.05

{BetaBlocker,ACEinh} 0.08 {Diuretik,

Antikoagulan,H2} 0.06 {Antiagregan,

Antikoagulan} 0.05

{Antiagregan,ACEinh} 0.08

{Antiagregan,Kalsiyum} 0.06 {Antikoagulan,

Kalsiyum} 0.05

{Antiagregan,Diuretik,Dijital}

0.07 {Dijital,Kalsiyum}

0.06 {Antikoagulan, H2,Lipid}

0.05

{Bronkodilator} 0.07 {Antikoagulan,Lipid,

BetaBlocker} 0.06 {Diuretik,Dijital,

BetaBlocker} 0.05

{Antikoagulan,ACEinh} 0.07 {Diuretik,Dijital,

Antikoagulan} 0.06



29.12.2011 41

CABG


{IVNitrat48s} 0.14


{Diuretik} 0.08








0.05



0.05


0.07


{H2,Lipid} 0.06



29.12.2011 42

VALVE




Kalsiyum} 0.06



0.06 {H2,ACEinh}

0.06

{Nitrogliserin} 0.08 {Diuretik, Dijital,

ACEinh} 0.06




Antikoagulan} 0.05



Kalsiyum} 0.05

{Antiagregan, Diuretik, Dijital}



0.05



BetaBlocker} 0.05


Antikoagulan} 0.06



29.12.2011 43

VALVE




Kalsiyum} 0.06



0.06 {H2,ACEinh}

0.06

{Nitrogliserin} 0.08 {Diuretik, Dijital,

ACEinh} 0.06




Antikoagulan} 0.05



Kalsiyum} 0.05

{Antiagregan, Diuretik, Dijital}



0.05



BetaBlocker} 0.05


Antikoagulan} 0.06



29.12.2011 44

CABG


{IVNitrat48s} 0.14


{Diuretik} 0.08








0.05



0.05


0.07


{H2,Lipid} 0.06

EXPERIMENTAL

RESULTS-3 DECISION TREE

29.12.2011 45


(Angio & Echo Measurements – Pump)

29.12.2011 46

1 : Off-pump

2 : On-pump


(Physical Examinations – Operation Type)

29.12.2011 47

1 : CABG

2 : Valve

CONCLUSION

• «KoronerArterSayısı» might affect decision of

operation techniques.

• Lower number of Coronery Artery, such as 1, 2, can be

operated without using the heart-lung machine (pump).

• «Hiperlipidemi» and «Hypertansion» do generally

cause Atherosclerosis when they occur in patient’s

body together.

29.12.2011 48

FUTURE WORK

• Combine all features and apply frequent itemsets

algorithm on the new dataset.

• Investigate the frequent itemset results for

«Preoperative Medication» features deeply.

29.12.2011 49

29.12.2011 50

CS-553 INTELLIGENT DATA ANALYSISguvenir/courses/CS553/Presentations/Can_F_Koyuncu.pdfCS-553 INTELLIGENT DATA ANALYSIS Effects of Preoperative Conditions of Patients on Surgery Types

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