Development and validation of machine learning models for predicting operative duration in assisted reproductive technology procedures

Abstract

BACKGROUND: Accurate prediction of operative duration is essential for efficient scheduling and resource allocation in surgical settings. In assisted reproductive technology (ART), procedures are brief yet highly time-sensitive, such that even small timing errors can propagate delays across tightly coupled workflows. This study aimed to develop and validate interpretable prediction models for operative duration in ART procedures using routinely available electronic medical record (EMR) data. METHODS: We retrospectively analyzed 763 operative cases from a high-volume fertility clinic in South Korea. Operative duration was defined using EMR-recorded start and end timestamps. Predictors included procedure type, patient age, reservation characteristics, attending physician, and day of surgery. We evaluated representative models from three commonly used predictive modeling paradigms-linear models, tree-based ensembles, and kernel/neural-network approaches-within a unified preprocessing and five-fold cross-validation framework. Model performance was assessed using standard error-based metrics and benchmarked against a commonly used moving-average heuristic. RESULTS: Among the evaluated approaches, regularized linear models-particularly ridge and Bayesian ridge regression-demonstrated stable and interpretable performance. After back-transformation to the original time scale, these models achieved a mean absolute error of approximately 3.1 min, corresponding to a 7-8% reduction compared with the moving-average (MA5) baseline. Procedure type, patient age, and reservation type emerged as the most influential predictors of operative duration. CONCLUSIONS: Using routinely available EMR data, interpretable linear models demonstrated consistent performance gains over a simple operational baseline. These results highlight the value of transparent and well-validated modeling strategies for operative duration prediction in high-throughput clinical settings. TRIAL REGISTRATION: Not applicable (retrospective study using de-identified EMR data).

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