Page 6 - CUA2018 Abstracts - Pediatric Urology

Poster session 7: Pediatrics

MP–7.6 times were recorded prospectively in the operating room by an unbiased
A contemporary comparison of traditional, open–access, and coder. The primary outcome was the trends of total and step–specific times
predatory publishing in pediatric urology and the first and last quartiles were compared using the Student’s t–test.
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Fardod O’Kelly , Nicolas Fernandez , Martin Koyle 2 Results: Thirty–nine RAP and 24 RUR were performed during the study
1 Pediatric Urology, Children Hospital of Eastern Ontario, Ottawa, ON, period. Age at surgery, laterality, and outcomes were similar in the first
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Canada; Pediatric Urology, The Hospital for Sick Children, Toronto, ON, and last quartiles (p>0.05). In the RAP cohort, the mean operative times
Canada decreased 35.4% (211 to 136 minutes), with maximal reductions noted in
Introduction: The burgeoning trend of open–access publishing allows for pelvic dismemberment and ureteral spatulation (69.7% reduction) and in
unrestricted and rapid knowledge dissemination. There are benefits for uretero–pelvic anastomosis (53.3% reduction). In the RUR cohort, mean
low–income countries, where interested parties may be unable to access operative times decreased 32.6% (223.7 to 150.8 minutes) with maximal
aarticles through traditional subscriptions, and allows for more egalitarian reductions in ureteral dissection (50.7% reduction) and suturing of the
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access. The open–access model has now appeared across a number of detrusor tunnel (56.7% reduction).
specialties and can generate higher citation levels than traditional mod- Conclusions: A reduction in intracorporeal suturing and spatulation time
els. However, the establishment of predatory journals has facilitated the (for RAP) and reduced suturing and ureteral dissection time (for RUR) are
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exploitation of this model and, for a cost, these predatory journals may responsible in reducing operative times for RAP and RUR, suggesting that
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publish work that has not gone through peer–review. The aim of this the primary benefit of the robotic platform is in aiding intracorporeal sutur-
study was to compare and analyze the incidence, characteristics, and ing and performing more complicated intracorporeal dissection maneuvers.
trends of publishing models in pediatric urology Despite a relatively low volume of robotic cases (14/year), this efficiency
Methods: A PubMed/Medline review was carried out for all articles using was achieved within the first 20 procedures for both RAP and RUR.
the terms “p(a)ediatric urology” over a five–year period from October 2012
to October 2017. These were all individually accessed and cross–checked MP–7.8
using Journal Citation Reports (JCR). Bibliometric data, journal type, and Machine learning and artificial intelligence to predict urinary
access model were all individually assessed, ranked, and compared. tract infections and continuous antibiotic prophylaxis in prenatal
Results: From an initial 4075 articles, 2244 met inclusion criteria. Open– hydronephrosis
access journals were more likely to publish scientific vs. clinical articles Yanbo Guo , Armando Lorenzo , Luis Braga 1
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(10.9% vs.3.3%; p<0.001). They were also more likely to have higher 1 Division of Urology, McMaster University, Hamilton, ON, Canada;
author (6.1 vs. 5.6; p=0.027), and patient (6291 vs.1139; p=0.015) num- 2 Division of Pediatric Urology, University of Toronto, Toronto, ON, Canada
bers, as well as higher average citations (31290 vs.13544; p=0.02). There Introduction: Prenatal hydronephrosis (PHN) affects up to 5% of infants.
was no difference in journal impact factors between models (3.1 vs. These children can undergo a battery of testing, develop urinary tract infec-
2.7; p=0.276). A total of 272 articles were from non–indexed journals. tions (UTI), and require continuous antibiotic prophylaxis (CAP). Current
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There was a higher number of predatory journals affecting open–access management strategies are based on subjective radiographic grading sys-
publishing (26.51% vs.1.29%; p<0.0001). tems. Being able to better identify patients who will need further interven-
Conclusions: Open–access, peer–reviewed publishing has led to increased tion will allow us to better target our investigations and management.
access with upfront costs, as well as higher average citations without The increasing availability of sophisticated machine learning and artificial
affecting impact factor. The authors conclude that caution is advised not to intelligence platforms provides a novel opportunity to build accurate
fall prey to predatory journals that seek to increase profits at the expense predictive models that are easy to distribute and use. We explored the
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of high publishing standards. application of this technology by creating a predictive model for patients
References: with PHN who will develop UTIs or require CAP.
1. Bowman DE, Wallace MB. Predatory journals: A serious compli- Methods: A de–identified prospective PHN database from McMaster
cation in the scholarly publishing landscape. Gastroint Endosc University was uploaded to the Microsoft Azure Machine Learning
®
2018;87: 273–4. https://doi.org/10.1016/j.gie.2017.09.019 Studio. Two models, a boosted decision tree learning model and an arti-
2. Chua SK, Quereshi AM, Krishnan V, et al. The impact factor of ficial neural network model, were trained. These were then scored against
an open–access journal does not contribute to an article’s cita- a test dataset and evaluated to determine the optimal model.
tions. F1000Res 2017;6: 208. https://doi.org/10.12688/f1000re- Results: Five hundred seventy–one entries were included. The model for
search.10892.1 UTI prediction achieved an area under the curve of 0.925. When sensitiv-
3. Beall J. Best practices for scholarly authors in the age of preda- ity is maximized, we achieved a sensitivity of 88%, specificity of 89%,
tory journals. Ann R Coll Surg Engl 2016; 98:77–9. https://doi. and accuracy of 0.889. The model for CAP prediction achieved an area
org/10.1308/rcsann.2016.0056 under the curve of 0.948. When sensitivity is maximized, we achieved a
4. Sorokowski P, Kulczycki E, Sorokowska A, et al. Predatory jour- sensitivity of 94%, specificity of 65%, and accuracy of 0.825.
nals recruit fake editor. Nature 2017;543:481–3. https://doi. Conclusions: We built two accurate predictive models with a commer-
org/10.1038/543481a cially available, easily accessible, cloud–based machine learning plat-
form. These models’ strong performance characteristics suggest their affin-
MP–7.7 ity to be used as screening tests to identify patients who require further
Studying the learning curve: A prospective study on step–specific evaluation and specialist consults. These emerging technologies provide
operative times for pediatric robotic–assisted pyeloplasty and an opportunity to surpass the current standard of predictive analytics and
reimplantation represent the next development in personalized medicine.
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Noah Stern , Roderick Clark , Zhan Tao (Peter) Wang , Sumit Dave 1 References:
1 Urology, London Health Sciences Centre, London, ON, Canada 1. Psooy K, Pike J. Investigation and management of antenatally
Introduction: The initiation of a pediatric robotic surgery program leads detected hydronephrosis. Can Urol Assoc J 2009;3;69–72. https://
to an increase in operative times, which incrementally increases health- doi.org/10.5489/cuaj.1027
care costs. This study investigates the learning curve of a single surgeon 2. Obermeyer Z, Emanuel E J. Predicting the future – Big data, machine
initiating robotic–assisted pyeloplasty (RAP) and robotic–assisted ureteral learning, and clinical medicine. N Engl J Med 2016;375:1216–9.
reimplantation (RUR) in the Canadian healthcare system. We hypoth- https://doi.org/10.1056/NEJMp1606181
esized that total operative times will decrease early in the learning curve,
primarily due to reduced intra–corporeal suturing times.
Methods: This prospective cohort study included all RAP and RUR proce-
dures performed between July 2013 and December 2017. Both operations
were sectioned into discrete operative steps and total and step–specific
CUAJ • June 2018 • Volume 12(6Suppl2) S103