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Letter to Editor: "Artificial Intelligence, Machine Learning, Deep Learning and

Big Data Analytics for Resource Optimization in Surgery"

Article  in  Indian Journal of Surgery · October 2020

DOI: 10.1007/s12262-020-02643-8

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Vikesh Agrawal Sanjay Kumar Yadav

Madhya Pradesh Medical Science University, Jabalpur Netaji Subash Chandra Bose Government Medical College Jabalpur
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Indian Journal of Surgery
https://doi.org/10.1007/s12262-020-02643-8

LETTER TO EDITOR

Letter to Editor: “Artificial Intelligence, Machine Learning, Deep

Learning and Big Data Analytics for Resource
Optimization in Surgery”
Vikesh Agrawal 1,2 & Dhananjaya Sharma 2 & Sanjay Kumar Yadav 2

Received: 3 September 2020 / Accepted: 14 October 2020

# Association of Surgeons of India 2020

Dear Editor,
Health care delivery in the pandemic is heavily disrupted.
There are high stakes and economic implications are huge
especially in more vulnerable low and middle-income group
countries (LMICs). It is even more imperative now that we
optimize our resources. Artificial intelligence (AI) and its
exploits should now be requisitioned. Two subsets of AI are
machine learning (ML) which in turn enables deep learning
(DL). Big data are analyzed [1]. Such tasks are complex and
will require yeoman efforts both on the parts individuals and
governments. The respective state and central governments
will provide regulatory sanctions. Preparations into big data
analysis, machine learning leading to deep learning is likely
to save resources. The current pandemic has amply shown
this and should prompt us to invest in AI. Efforts and in-
vestment in deep learning should be translational in re-
source allocation and resource triage even during normal
settings. We have written an iterative algorithm that should
convince the stakeholders to invest in this modality (Fig. 1).

* Vikesh Agrawal
drvikeshagrawal@gmail.com

Dhananjaya Sharma
dhanshar@gmail.com
Sanjay Kumar Yadav
sky1508@gmail.com

1
Pediatric Surgery Division, Department of Surgery, Netaji Subhash
Chandra Bose Government Medical College, Nagpur Road,
Jabalpur 482003, India
2
Department of Surgery, Netaji Subhash Chandra Bose Government
Medical College, Nagpur Road, Jabalpur 482003, India
 Indian J Surg

Fig. 1 Resource-optimization
algorithm based on four-level risk Elective surgery
Input Data
stratification for elective surgical
services during pandemic and the
Risk stratification- I
proposed deep learning module. Optimization Strategy I
Clinical categorization
PPE- Personal Protective Elective surgery triage
(Based on Symptoms) Machine learning
Equipment, AGP- Aerosol
Generating Procedure, ICU-
Intensive Care Unit Suspected/ Unsuspected
Predictive model

Risk stratification- II Optimization Strategy II

Infection categorization Testing/ Imaging resources
Output Commands

Detected/ Undetected

Risk stratification- III Optimization Strategy III

Transmission Human/ PPE resources
categorization
(Based on AGP)

Unrestricted (NAGP)/
Restricted(AGP)

Risk stratification- IV Optimization Strategy IV

Outcome categorization ICU resources
(Based on severity of disease)

High risk/ Low risk

Compliance with Ethical Standards

Conflict of Interest The authors declare that they have no conflict of

interest.

Reference
1. Al Knawy B, Adil M, Crooks G, Rhee K, Bates D, Jokhdar H, Klag
M, Lee U, Mokdad AH, Schaper L, Al Hazme R, Al Khathaami AM,
Abduljawad J (2020) The Riyadh Declaration: the role of digital
health in fighting pandemics. Lancet S0140–6736(20):31978–
31974. https://doi.org/10.1016/S0140-6736(20)31978-4

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