Predicting operative time for metabolic and bariatric surgery using machine learning models: A retrospective observational study.

BACKGROUND:Predicting operative time is essential for scheduling surgery and managing the operating room (OR). This study aimed to develop machine learning (ML) models to predict the operative time for metabolic and bariatric surgery (MBS) and to compare each model. METHODS:We used the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database between 2016 and 2020 to develop ML models, including linear regression, random forest (RF), support vector machine, gradient-boosted tree, and XGBoost model. Patient characteristics and surgical features were included as variables in the model. We used the mean absolute error (MAE), root mean square error (RMSE), and R2 score to evaluate model performance. We identified the ten most important variables in the best-performing model using the Shapley Additive exPlanations algorithm. RESULTS:In total, 668,723 patients were included in the study. The XGBoost model outperformed the other ML models, with the lowest RMSE and highest R2 score. RF performed better than linear regression. The relative performance of the ML algorithms remained consistent across the models, regardless of the surgery type. The surgery type and surgical approach were the most important features to predict the operative time; specifically, sleeve gastrectomy (vs. Roux-en-Y gastric bypass) and the laparoscopic approach (vs. robotic-assisted approach) were associated with a shorter operative time. CONCLUSIONS:The XGBoost model best predicted the operative time for MBS among the ML models examined. Our findings can be useful in managing OR scheduling and in developing software tools to predict the operative times of MBS in clinical settings.