An artificial-intelligence-based clinical decision support application reduces the rate of adverse clinical events (original) (raw)
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Nature Medicine
he prospect of improved clinical outcomes and more efficient health systems has fueled a rapid rise in the development and evaluation of AI systems over the last decade. Because most AI systems within healthcare are complex interventions designed as clinical decision support systems, rather than autonomous agents, the interactions among the AI systems, their users and the implementation environments are defining components of the AI interventions' overall potential effectiveness. Therefore, bringing AI systems from mathematical performance to clinical utility needs an adapted, stepwise implementation and evaluation pathway, addressing the complexity of this collaboration between two independent forms of intelligence, beyond measures of effectiveness alone 1. Despite indications that some AI-based algorithms now match the accuracy of human experts within preclinical in silico studies 2 , there Reporting guideline for the early-stage clinical evaluation of decision support systems driven by artificial intelligence: DECIDE-AI
Yearbook of Medical Informatics, 2019
Objectives: This paper draws attention to: i) key considerations for evaluating artificial intelligence (AI) enabled clinical decision support; and ii) challenges and practical implications of AI design, development, selection, use, and ongoing surveillance. Method: A narrative review of existing research and evaluation approaches along with expert perspectives drawn from the International Medical Informatics Association (IMIA) Working Group on Technology Assessment and Quality Development in Health Informatics and the European Federation for Medical Informatics (EFMI) Working Group for Assessment of Health Information Systems. Results: There is a rich history and tradition of evaluating AI in healthcare. While evaluators can learn from past efforts, and build on best practice evaluation frameworks and methodologies, questions remain about how to evaluate the safety and effectiveness of AI that dynamically harness vast amounts of genomic, biomarker, phenotype, electronic record, and...
A Clinical Feasibility Study of an Artificial Intelligence-Powered Clinical Decision Support System
Objective: We examine the feasibility of an Artificial Intelligence (AI)-powered clinical decision support system (CDSS), which combines the operationalized 2016 Canadian Network for Mood and Anxiety Treatments guidelines with a neural-network based individualized treatment remission prediction. Methods: Due to COVID-19, the study was adapted to be completed entirely at a distance. Seven physicians recruited outpatients diagnosed with major depressive disorder (MDD) as per DSM-V criteria. Patients completed a minimum of one visit without the CDSS (baseline) and two subsequent visits where the CDSS was used by the physician (visit 1 and 2). The primary outcome of interest was change in session length after CDSS introduction, as a proxy for feasibility. Feasibility and acceptability data were collected through self-report questionnaires and semi-structured interviews. Results: Seventeen patients enrolled in the study; 14 completed. There was no significant difference between appointme...
Artificial Intelligence in Clinical Decision Support: a Focused Literature Survey
Yearbook of Medical Informatics
Objectives: This survey analyses the latest literature contributions to clinical decision support systems (DSSs) on a two-year period (2017-2018), focusing on the approaches that adopt Artificial Intelligence (AI) techniques in a broad sense. The goal is to analyse the distribution of data-driven AI approaches with respect to “classical" knowledge-based ones, and to consider the issues raised and their possible solutions. Methods: We included PubMed and Web of ScienceTM publications, focusing on contributions describing clinical DSSs that adopted one or more AI methodologies. Results: We selected 75 papers, 49 of which describe approaches in the data-driven AI area, 20 present purely knowledge-based DSSs, and 6 adopt hybrid approaches relying on both formalized knowledge and data. Conclusions: Recent studies in the clinical DSS area demonstrate a prevalence of data-driven AI, which can be adopted autonomously in purely data-driven systems, or in cooperation with domain knowledg...
Review Article Artificial intelligence in clinical research
2016
Envision dedicating fifteen years to a critical interest and emptying staggering amount of funds into it, at the same time confronting a disappointment rate of 95 percent. That is the crippling reality for pharmaceutical organizations, which toss billions of dollars consistently toward medications that possible won't work – and after that do a reversal to the planning phase and do it once more. Today's medications go to the business sector after an extensive, very costly process of drug development. It takes anywhere in the range of 10 to 15 years, here and there significantly more, to convey a medication from introductory revelation to the hands of patients – and that voyage can cost billions up to 12 billion, to be correct. That is just a lot to spend, and excessively yearn for patients to hold up. Patients can hardly wait 15 years for a lifesaving drug, we require another productive focused on medication revelation and improvement process. Artificial Intelligence, can sig...
A Review of Clinical Research Incorporating Artificial Intelligence Analyses
2019
Artificial Intelligence is increasingly being used in medical research and certain clinical practice areas. This article examines selected literature to identify common themes with an idea to understanding the impact, concerns and opportunities afforded by such technology. Such research is markedly different from established research methodologies and so is challenging to assess and evaluate. The complexity of the analytics and applied statistics makes it difficult for many to understand and yet conclusions drawn can have a significant impact on clinical practice and policy, funding and recording practices. The key themes identified are those of accuracy, population bias, database limitations, costand time-savings, and the ability to use artificial intelligence to predict future events or outcomes. In addition, certain dangers are highlighted and a few recommendations made.
Artificial Intelligence Applications in Decision Making for Disease Management
Background: Artificial intelligence (AI) has several potential applications in medicine, creating opportunities for reliable and evidence based decision making in disease management. Thus, the practical aspects of AI in decision-making should be identified. This study was conducted to identify AI applications in decision making for disease management. Method: This study was a systematic review using the PRISMA-ScR checklist. Data collection was carried out by searching the related keywords in WOS and Scopus in May 2023. Results: Regarding the AI applications in decision making for disease management, we found 80 sub-themes which were categorized into six themes, i.e. 1) Processing and managing data, 2) Characterization and analysis, 3) Prediction and risk stratification, 4) Screening, 5) Prognosis, and 6) Diagnosis. Conclusion: AI has considerable capability in disease treatment and would be an integral part of medicine in the future. This study clearly identified six main themes th...