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Table · dataset · 2026

Data Sheet 1_Prediction of moderate-to-severe postoperative thirst in general anesthesia patients based on automated machine learning and clinical nursing translation.docx

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Objective<p>To develop an Automated Machine Learning (AutoML)-based model for screening Moderate-to-Severe Postoperative Thirst (MSPOT) risk at surgery-to-PACU handover and a prototype clinical decision support system.</p>Methods<p>This retrospective single-center cohort included 928 patients undergoing general anesthesia (training set: n = 650; held-out internal test set: n = 278). An Improved Wave Optics Optimizer (IWOO) framework integrated feature selection and hyperparameter optimization using demographic, preoperative, and intraoperative variables.

Prediction was performed at anesthesia-to-PACU handover, after final intraoperative data became available and before routine postoperative NRS thirst assessment. Performance was evaluated using ROC-AUC, PR-AUC, calibration analysis, Brier score, and decision curve analysis (DCA). SHAP was used to summarize feature contributions.</p>Results<p>In the held-out internal test set, the AutoML model achieved a ROC-AUC of 0.9053, PR-AUC of 0.9080, and Brier score of 0.129, outperforming conventional models.

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DCA showed greater net benefit across thresholds of 1%–95%. In same-center temporal validation, discrimination remained acceptable (ROC-AUC: 0.8807; PR-AUC: 0.8778), but calibration deteriorated (Brier score: 0.1924; intercept: −1.2250; slope: 0.5811), indicating average risk overestimation and overly extreme probabilities. Six predictors were identified: esmolol use, intraoperative blood loss, operation time, ASA classification, ERAS, and intraoperative fluid volume.</p>Conclusions<p>The AutoML model showed strong discrimination and transparent feature attribution.

The prototype illustrates its potential use at PACU handover to prioritize early assessment and comfort-oriented thirst management. However, temporal miscalibration indicates that individualized probabilities are not ready for clinical decision-making without recalibration and subsequent prospective validation.</p>

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