Title of study: Development of a Prognostic Naïve Bayesian Classifier for Successful Treatment of Nonunions

Authors: Alexander Stojadinovic, MD, Benjamin Kyle Potter, MD, John Eberhardt, BA, Scott B. Shawen, MD, Romney C. Andersen, MD, Jonathan A. Forsberg, MD, Clay Shwery, MS, Eric A. Ester, MD, and Wolfgang Schaden, MD

This study aimed to develop a predictive model for individualized prognosis in patients with fracture nonunion treated with extracorporeal shock wave therapy. The study used data from 349 patients with delayed fracture union or nonunion to develop a naïve Bayesian belief network model to estimate site-specific fracture-nonunion healing. The results showed that the time between the fracture and the first shock wave treatment, the time between the fracture and the surgery, intramedullary stabilization, the number of bone-grafting procedures, the number of shock wave therapy treatments, work-related injury, and the bone involved significantly impacted healing outcomes. These variables were all included in the model, which proved clinically relevant in predicting the outcome after extracorporeal shock wave therapy for fracture nonunions.

The study findings suggest that the predictive model can help in personalized prognostication for patients with fracture nonunion, which is currently lacking. The model also highlights the impact of various factors on healing outcomes, allowing healthcare professionals to make informed decisions in treatment planning. While the study population was limited to patients treated with shock wave therapy, the authors suggest that Bayesian-derived predictive models may be developed for application to other fracture populations at risk for nonunion.

Overall, this study provides important insights into the use of extracorporeal shock wave therapy in treating fracture nonunions and highlights the potential benefits of using predictive models to improve treatment outcomes. The findings may have implications for the development of personalized treatment plans for patients with fracture nonunion, which could improve healing rates and patient outcomes.