Use of machine learning to conduct systematic reviews of patient values and preferences in the context of guideline development

Article type
Authors
Zhang Y1, Pérez Rada D2, Etxeandia-Ikobaltzeta I1, Rada G3, Vásquez J2, Wiercioch W1, Nieuwlaat R1, Couban R4, Schünemann H1
1Department of Health Research Methods, Evidence, and Impact, McMaster University
2Epistemonikos
3Department of Internal Medicine and Evidence-Based Healthcare Program, Pontificia Universidad Católica de Chile, Santiago
4McMaster University
Abstract
Background: In the context of clinical practice guideline development we conducted a systematic review on patient values and preferences, or how patients value healthcare outcomes, following the GRADE evidence-to-decision framework. Challenges with these systematic reviews arise as a sensitive search strategy results in a large number of citations to screen, so alternative strategies to balance sensitivity and feasibility are needed.

Objectives: To describe our experience of using a machine-learning model to exclude citations for screening in the context of a large systematic review.

Methods:We ran a sensitive search strategy in MEDLINE and EMBASE. We used the Collaboratron™ platform for: the screening in duplicate of a training sample of the search results (records from 2014 to 2016); the development of a machine-learning model to predict the probability of inclusion of a reference; and, the implementation of the model in the remaining records to be screened. For the machine-learning model we arbitrarily used a score of 0.01 (i.e. 1% probability of an article being relevant) to exclude irrelevant records.

Results: From 48 563 records we screened 10 193 in order to create the training set.
The predicted accuracy of the model was 87.5.% sensitivity and 92.3% specificity, which left 2983 records to screen from the remaining 38 370.

Conclusions: The application of a machine-learning model substantially decreased the workload associated with the screening of a very large number of records. This approach might be useful when a small loss of relevant studies is acceptable.