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Bhattacharya S, Saleem SM, Singh A, Singh S, Tripathi S. Empowering precision medicine: regenerative AI in breast cancer. Front Oncol 2024; 14:1465720. [PMID: 39372870 PMCID: PMC11449872 DOI: 10.3389/fonc.2024.1465720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 08/27/2024] [Indexed: 10/08/2024] Open
Abstract
Regenerative AI is transforming breast cancer diagnosis and treatment through enhanced imaging analysis, personalized medicine, drug discovery, and remote patient monitoring. AI algorithms can detect subtle patterns in mammograms and other imaging modalities with high accuracy, potentially leading to earlier diagnoses. In treatment planning, AI integrates patient-specific data to predict individual responses and optimize therapies. For drug discovery, generative AI models rapidly design and screen novel molecules targeting breast cancer pathways. Remote monitoring tools powered by AI provide real-time insights to guide care. Examples include Google's LYNA for analyzing pathology slides, Kheiron's Mia for mammogram interpretation, and Tempus's platform for integrating clinical and genomic data. While promising, challenges remain, including limited high-quality training data, integration into clinical workflows, interpretability of AI decisions, and regulatory/ethical concerns. Strategies to address these include collaborative data-sharing initiatives, user-centered design, explainable AI techniques, and robust oversight frameworks. In developing countries, AI tools like MammoAssist and Niramai's thermal imaging system are improving access to screening. Overall, regenerative AI offers significant potential to enhance breast cancer care, but judicious implementation with awareness of limitations is crucial. Coordinated efforts across the healthcare ecosystem are needed to fully realize AI's benefits while addressing challenges.
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Affiliation(s)
- Sudip Bhattacharya
- Department of Community and Family Medicine, All India Institute of Medical Sciences, (AIIMS Deoghar), Deoghar, India
| | - Sheikh Mohd Saleem
- Department of Health and Family Welfare, EVTHS, UNICEF, New Delhi, India
| | - Alok Singh
- Faculty of Medicine and Health Sciences, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana, India
| | - Sukhpreet Singh
- Department of Health and Family Welfare, Haryana Civil Medical Services (HCMS), Panchkula, Haryana, India
| | - Shailesh Tripathi
- Department of Hospital Administration, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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Zhou X, Wei T. Application of multi-disciplinary team nursing model enhances recovery after surgery for total hip arthroplasty and total knee arthroplasty. Am J Transl Res 2024; 16:3938-3949. [PMID: 39262755 PMCID: PMC11384419 DOI: 10.62347/bhgs1734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 07/14/2024] [Indexed: 09/13/2024]
Abstract
AIM To explore the effect of a multidisciplinary team (MDT) nursing model based on enhanced recovery after surgery (ERAS) in total hip arthroplasty (THA)/total knee arthroplasty (TKA) and evaluate its application in the perioperative period of patients. METHODS A retrospective analysis was conducted on 100 patients with THA/TKA treated at Shaoxing Second Hospital Medical Community General Hospital from January 2021 to December 2023. The patients were divided into an observation group (n = 50) and a control group (n = 50) based on the nursing method employed. The control group received traditional perioperative nursing, while the observation group received an MDT nursing model intervention based on the ERAS concept. Visual analogue scale (VAS) scores were recorded at 6, 24, and 72 hours post-surgery. Additionally, postoperative activities, hospitalization duration, and postoperative complications were documented. Differences in knee joint range of motion (ROM), hip Harris score, psychological stress response score, and quality of life score between the two groups before and one month after surgery were analyzed. RESULTS At 6, 24, and 72 hours post-surgery, patients in the observation group had significantly lower VAS scores compared to those in the control group (all P < 0.05). The observation group had an earlier first-time mobilization (P < 0.05). The length of hospitalization and hospitalization cost were significantly lower in the observation group than in the control group (both P < 0.05). The incidence rates of postoperative adverse reactions were 22.00% in the control group and 6.00% in the observation group (P < 0.05). One month post-surgery, the observation group showed significantly greater ROM, lower psychological stress and reaction scores, and higher Harris score and quality of life score compared to the control group (all P < 0.05). CONCLUSION The MDT nursing model based on ERAS concept for THA/TKA perioperative patients effectively alleviates postoperative pain, promotes early activity, shortens hospital stay, reduces hospital cost, decreases the incidence of complications, restores joint function, enhances quality of life, and reduces psychological stress.
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Affiliation(s)
- Xiudan Zhou
- Orthopedic Second Ward, Shaoxing Second Hospital Medical Community General Hospital Shaoxing 312000, Zhejiang, China
| | - Tianfei Wei
- Orthopedic Second Ward, Shaoxing Second Hospital Medical Community General Hospital Shaoxing 312000, Zhejiang, China
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Storman D, Jemioło P, Sawiec Z, Swierz MJ, Antonowicz E, Bala MM, Prokop-Dorner A. Needs Expressed in Peer-to-Peer Web-Based Interactions Among People With Depression and Anxiety Disorders Hospitalized in a Mental Health Facility: Mixed Methods Study. J Med Internet Res 2024; 26:e51506. [PMID: 38996331 DOI: 10.2196/51506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 04/03/2024] [Accepted: 05/06/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Hospitalization in psychiatric wards is a necessary step for many individuals experiencing severe mental health issues. However, being hospitalized can also be a stressful and unsettling experience. It is crucial to understand and address the various needs of hospitalized individuals with psychiatric disorders to promote their overall well-being and support their recovery. OBJECTIVE Our objectives were to identify and describe individual needs related to mental hospitals through peer-to-peer interactions on Polish web-based forums among individuals with depression and anxiety disorders and to assess whether these needs were addressed by peers. METHODS We conducted a search of web-based forums focused on depression and anxiety and selected samples of 160 and 176 posts, respectively, until we reached saturation. A mixed methods analysis that included an in-depth content analysis, the Pearson χ2 test, and φ coefficient was used to evaluate the posts. RESULTS The most frequently identified needs were the same for depression and anxiety forums and involved informational (105/160, 65.6% and 169/393, 43%, respectively), social life (17/160, 10.6% and 90/393, 22.9%, respectively), and emotional (9/160, 5.6% and 66/393, 16.8%, respectively) needs. The results show that there is no difference in the expression of needs between the analyzed forums. The needs were directly (42/47, 89% vs 98/110, 89.1% of times for depression and anxiety, respectively) and not fully (27/47, 57% vs 86/110, 78.2% of times for depression and anxiety, respectively) addressed by forum users. In quantitative analysis, we found that depression-related forums had more posts about the need for informational support and rectification, the expression of anger, and seeking professional support. By contrast, anxiety-related forums had more posts about the need for emotional support; social life; and information concerning medications, hope, and motivation. The most common co-occurrence of expressed needs was between sharing own experience and the need for professional support, with a strong positive association. The qualitative analysis showed that users join web-based communities to discuss their fears and questions about psychiatric hospitals. The posts revealed 4 mental and emotional representations of psychiatric hospitals: the hospital as an unknown place, the ambivalence of presumptions and needs, the negative representation of psychiatric hospitals, and the people associated with psychiatric hospitals. The tone of the posts was mostly negative, with discussions revolving around negative stereotypes; traumatic experiences; and beliefs that increased anxiety, shock, and fright and deterred users from hospitalization. CONCLUSIONS Our study demonstrates that web-based forums can provide a platform for individuals with depression and anxiety disorders to express a wide range of needs. Most needs were addressed by peers but not sufficiently. Mental health professionals can benefit from these findings by gaining insights into the unique needs and concerns of their patients, thus allowing for more effective treatment and support.
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Affiliation(s)
- Dawid Storman
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kraków, Poland
| | | | - Zuzanna Sawiec
- Students' Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, Kraków, Poland
| | - Mateusz Jan Swierz
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kraków, Poland
| | - Ewa Antonowicz
- Students' Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, Kraków, Poland
| | - Malgorzata M Bala
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Prokop-Dorner
- Chair of Epidemiology and Preventive Medicine, Department of Medical Sociology, Jagiellonian University Medical College, Kraków, Poland
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Gairola S, Solanki SL, Patkar S, Goel M. Artificial Intelligence in Perioperative Planning and Management of Liver Resection. Indian J Surg Oncol 2024; 15:186-195. [PMID: 38818006 PMCID: PMC11133260 DOI: 10.1007/s13193-024-01883-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/16/2024] [Indexed: 06/01/2024] Open
Abstract
Artificial intelligence (AI) is a speciality within computer science that deals with creating systems that can replicate the intelligence of a human mind and has problem-solving abilities. AI includes a diverse array of techniques and approaches such as machine learning, neural networks, natural language processing, robotics, and expert systems. An electronic literature search was conducted using the databases of "PubMed" and "Google Scholar". The period for the search was from 2000 to June 2023. The search terms included "artificial intelligence", "machine learning", "liver cancers", "liver tumors", "hepatectomy", "perioperative" and their synonyms in various combinations. The search also included all MeSH terms. The extracted articles were further reviewed in a step-wise manner for identification of relevant studies. A total of 148 articles were identified after the initial literature search. Initial review included screening of article titles for relevance and identifying duplicates. Finally, 65 articles were reviewed for this review article. The future of AI in liver cancer planning and management holds immense promise. AI-driven advancements will increasingly enable precise tumour detection, location, and characterisation through enhanced image analysis. ML algorithms will predict patient-specific treatment responses and complications, allowing for tailored therapies. Surgical robots and AI-guided procedures will enhance the precision of liver resections, reducing risks and improving outcomes. AI will also streamline patient monitoring, better hemodynamic management, enabling early detection of recurrence or complications. Moreover, AI will facilitate data-driven research, accelerating the development of novel treatments and therapies. Ultimately, AI's integration will revolutionise liver cancer care, offering personalised, efficient and effective solutions, improving patients' quality of life and survival rates.
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Affiliation(s)
- Shruti Gairola
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra India
| | - Sohan Lal Solanki
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra India
| | - Shraddha Patkar
- Division of Hepatobiliary Surgical Oncology, Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra India
| | - Mahesh Goel
- Division of Hepatobiliary Surgical Oncology, Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra India
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Hendriks MP, Jager A, Ebben KCWJ, van Til JA, Siesling S. Clinical decision support systems for multidisciplinary team decision-making in patients with solid cancer: Composition of an implementation model based on a scoping review. Crit Rev Oncol Hematol 2024; 195:104267. [PMID: 38311011 DOI: 10.1016/j.critrevonc.2024.104267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 12/18/2023] [Accepted: 01/11/2024] [Indexed: 02/06/2024] Open
Abstract
Generating guideline-based recommendations during multidisciplinary team (MDT) meetings in solid cancers is getting more complex due to increasing amount of information needed to follow the guidelines. Usage of clinical decision support systems (CDSSs) can simplify and optimize decision-making. However, CDSS implementation is lagging behind. Therefore, we aim to compose a CDSS implementation model. By performing a scoping review of the currently reported CDSSs for MDT decision-making we determined 102 barriers and 86 facilitators for CDSS implementation out of 44 papers describing 20 different CDSSs. The most frequently reported barriers and facilitators for CDSS implementation supporting MDT decision-making concerned CDSS maintenance (e.g. incorporating guideline updates), validity of recommendations and interoperability with electronic health records. Based on the identified barriers and facilitators, we composed a CDSS implementation model describing clinical utility, analytic validity and clinical validity to guide CDSS integration more successfully in the clinical workflow to support MDTs in the future.
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Affiliation(s)
- Mathijs P Hendriks
- Department of Health Technology and Services Research, Technical Medical Center, University of Twente, PO Box 217, 7500 AE Enschede, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), PO Box 19079, 3501 DB Utrecht, the Netherlands; Department of Medical Oncology, Northwest Clinics, PO Box 501, 1800 AM Alkmaar, the Netherlands.
| | - Agnes Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - Kees C W J Ebben
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), PO Box 19079, 3501 DB Utrecht, the Netherlands.
| | - Janine A van Til
- Department of Health Technology and Services Research, Technical Medical Center, University of Twente, PO Box 217, 7500 AE Enschede, the Netherlands.
| | - Sabine Siesling
- Department of Health Technology and Services Research, Technical Medical Center, University of Twente, PO Box 217, 7500 AE Enschede, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), PO Box 19079, 3501 DB Utrecht, the Netherlands.
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Tan M, Xiao Y, Jing F, Xie Y, Lu S, Xiang M, Ren H. Evaluating machine learning-enabled and multimodal data-driven exercise prescriptions for mental health: a randomized controlled trial protocol. Front Psychiatry 2024; 15:1352420. [PMID: 38287940 PMCID: PMC10822920 DOI: 10.3389/fpsyt.2024.1352420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/02/2024] [Indexed: 01/31/2024] Open
Abstract
Background Mental illnesses represent a significant global health challenge, affecting millions with far-reaching social and economic impacts. Traditional exercise prescriptions for mental health often adopt a one-size-fits-all approach, which overlooks individual variations in mental and physical health. Recent advancements in artificial intelligence (AI) offer an opportunity to tailor these interventions more effectively. Objective This study aims to develop and evaluate a multimodal data-driven AI system for personalized exercise prescriptions, targeting individuals with mental illnesses. By leveraging AI, the study seeks to overcome the limitations of conventional exercise regimens and improve adherence and mental health outcomes. Methods The study is conducted in two phases. Initially, 1,000 participants will be recruited for AI model training and testing, with 800 forming the training set, augmented by 9,200 simulated samples generated by ChatGPT, and 200 as the testing set. Data annotation will be performed by experienced physicians from the Department of Mental Health at Guangdong Second Provincial General Hospital. Subsequently, a randomized controlled trial (RCT) with 40 participants will be conducted to compare the AI-driven exercise prescriptions against standard care. Assessments will be scheduled at 6, 12, and 18 months to evaluate cognitive, physical, and psychological outcomes. Expected outcomes The AI-driven system is expected to demonstrate greater effectiveness in improving mental health outcomes compared to standard exercise prescriptions. Personalized exercise regimens, informed by comprehensive data analysis, are anticipated to enhance participant adherence and overall mental well-being. These outcomes could signify a paradigm shift in exercise prescription for mental health, paving the way for more personalized and effective treatment modalities. Registration and ethical approval This is approved by Human Experimental Ethics Inspection of Guangzhou Sport University, and the registration is under review by ChiCTR.
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Affiliation(s)
| | - Yanning Xiao
- China Swimming College, Beijing Sport University, Beijing, China
- China’s National Artistic Swimming Team, Beijing, China
- Institute of Physical Education, Sichuan University, Chengdu, China
| | - Fengshi Jing
- Faculty of Data Science, City University of Macau, Taipa, Macao SAR, China
- Project-China, School of Medicine, The University of North Carolina, Chapel Hill, NC, United States
- College of Business, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yewei Xie
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Sanmei Lu
- South China Agricultural University, Guangzhou, China
| | | | - Hao Ren
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Guangzhou, China
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Yang X, Huang K, Yang D, Zhao W, Zhou X. Biomedical Big Data Technologies, Applications, and Challenges for Precision Medicine: A Review. GLOBAL CHALLENGES (HOBOKEN, NJ) 2024; 8:2300163. [PMID: 38223896 PMCID: PMC10784210 DOI: 10.1002/gch2.202300163] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/20/2023] [Indexed: 01/16/2024]
Abstract
The explosive growth of biomedical Big Data presents both significant opportunities and challenges in the realm of knowledge discovery and translational applications within precision medicine. Efficient management, analysis, and interpretation of big data can pave the way for groundbreaking advancements in precision medicine. However, the unprecedented strides in the automated collection of large-scale molecular and clinical data have also introduced formidable challenges in terms of data analysis and interpretation, necessitating the development of novel computational approaches. Some potential challenges include the curse of dimensionality, data heterogeneity, missing data, class imbalance, and scalability issues. This overview article focuses on the recent progress and breakthroughs in the application of big data within precision medicine. Key aspects are summarized, including content, data sources, technologies, tools, challenges, and existing gaps. Nine fields-Datawarehouse and data management, electronic medical record, biomedical imaging informatics, Artificial intelligence-aided surgical design and surgery optimization, omics data, health monitoring data, knowledge graph, public health informatics, and security and privacy-are discussed.
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Affiliation(s)
- Xue Yang
- Department of Pancreatic Surgery and West China Biomedical Big Data CenterWest China HospitalSichuan UniversityChengdu610041China
| | - Kexin Huang
- Department of Pancreatic Surgery and West China Biomedical Big Data CenterWest China HospitalSichuan UniversityChengdu610041China
| | - Dewei Yang
- College of Advanced Manufacturing EngineeringChongqing University of Posts and TelecommunicationsChongqingChongqing400000China
| | - Weiling Zhao
- Center for Systems MedicineSchool of Biomedical InformaticsUTHealth at HoustonHoustonTX77030USA
| | - Xiaobo Zhou
- Center for Systems MedicineSchool of Biomedical InformaticsUTHealth at HoustonHoustonTX77030USA
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Pagallo U, O’Sullivan S, Nevejans N, Holzinger A, Friebe M, Jeanquartier F, Jean-Quartier C, Miernik A. The underuse of AI in the health sector: Opportunity costs, success stories, risks and recommendations. HEALTH AND TECHNOLOGY 2023; 14:1-14. [PMID: 38229886 PMCID: PMC10788319 DOI: 10.1007/s12553-023-00806-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/16/2023] [Indexed: 01/18/2024]
Abstract
Purpose This contribution explores the underuse of artificial intelligence (AI) in the health sector, what this means for practice, and how much the underuse can cost. Attention is drawn to the relevance of an issue that the European Parliament has outlined as a "major threat" in 2020. At its heart is the risk that research and development on trusted AI systems for medicine and digital health will pile up in lab centers without generating further practical relevance. Our analysis highlights why researchers, practitioners and especially policymakers, should pay attention to this phenomenon. Methods The paper examines the ways in which governments and public agencies are addressing the underuse of AI. As governments and international organizations often acknowledge the limitations of their own initiatives, the contribution explores the causes of the current issues and suggests ways to improve initiatives for digital health. Results Recommendations address the development of standards, models of regulatory governance, assessment of the opportunity costs of underuse of technology, and the urgency of the problem. Conclusions The exponential pace of AI advances and innovations makes the risks of underuse of AI increasingly threatening. Graphical Abstract
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Affiliation(s)
- Ugo Pagallo
- Law School, University of Turin, Turin, Italy
| | - Shane O’Sullivan
- Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Freiburg im Breisgau, Germany
| | - Nathalie Nevejans
- Ethics and Procedures Center (CDEP), Faculty of Law of Douai, University of Artois, Arras, France
| | - Andreas Holzinger
- Human-Centered AI Lab, Medical University of Graz, Graz, Austria
- University of Natural Resources and Life Sciences Vienna, Human-Centered AI Lab, Vienna, Austria
| | - Michael Friebe
- Department of Measurements and Electronics, AGH University of Science and Technology, Krak’ow, Poland
- Faculty of Medicine, Otto-von-Guericke-University, Magdeburg, Germany
- Center for Innovation and Business Development, FOM University of Applied Sciences, Essen, Germany
| | | | | | - Arkadiusz Miernik
- Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Freiburg im Breisgau, Germany
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Gao T, Ren H, He S, Liang D, Xu Y, Chen K, Wang Y, Zhu Y, Dong H, Xu Z, Chen W, Cheng W, Jing F, Tao X. Development of an interpretable machine learning-based intelligent system of exercise prescription for cardio-oncology preventive care: A study protocol. Front Cardiovasc Med 2023; 9:1091885. [PMID: 38106819 PMCID: PMC10722170 DOI: 10.3389/fcvm.2022.1091885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/12/2022] [Indexed: 12/19/2023] Open
Abstract
Background Cardiovascular disease (CVD) and cancer are the first and second causes of death in over 130 countries across the world. They are also among the top three causes in almost 180 countries worldwide. Cardiovascular complications are often noticed in cancer patients, with nearly 20% exhibiting cardiovascular comorbidities. Physical exercise may be helpful for cancer survivors and people living with cancer (PLWC), as it prevents relapses, CVD, and cardiotoxicity. Therefore, it is beneficial to recommend exercise as part of cardio-oncology preventive care. Objective With the progress of deep learning algorithms and the improvement of big data processing techniques, artificial intelligence (AI) has gradually become popular in the fields of medicine and healthcare. In the context of the shortage of medical resources in China, it is of great significance to adopt AI and machine learning methods for prescription recommendations. This study aims to develop an interpretable machine learning-based intelligent system of exercise prescription for cardio-oncology preventive care, and this paper presents the study protocol. Methods This will be a retrospective machine learning modeling cohort study with interventional methods (i.e., exercise prescription). We will recruit PLWC participants at baseline (from 1 January 2025 to 31 December 2026) and follow up over several years (from 1 January 2027 to 31 December 2028). Specifically, participants will be eligible if they are (1) PLWC in Stage I or cancer survivors from Stage I; (2) aged between 18 and 55 years; (3) interested in physical exercise for rehabilitation; (4) willing to wear smart sensors/watches; (5) assessed by doctors as suitable for exercise interventions. At baseline, clinical exercise physiologist certificated by the joint training program (from 1 January 2023 to 31 December 2024) of American College of Sports Medicine and Chinese Association of Sports Medicine will recommend exercise prescription to each participant. During the follow-up, effective exercise prescription will be determined by assessing the CVD status of the participants. Expected outcomes This study aims to develop not only an interpretable machine learning model to recommend exercise prescription but also an intelligent system of exercise prescription for precision cardio-oncology preventive care. Ethics This study is approved by Human Experimental Ethics Inspection of Guangzhou Sport University. Clinical trial registration http://www.chictr.org.cn, identifier ChiCTR2300077887.
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Affiliation(s)
- Tianyu Gao
- School of Physical Education, Jinan University, Guangzhou, China
| | - Hao Ren
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Guangzhou, China
- Faculty of Data Science, City University of Macau, Macao, Macao SAR, China
| | - Shan He
- Guangzhou Sport University, Guangzhou, China
| | - Deyi Liang
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Yuming Xu
- Division of Physical Education, Guangdong University of Finance and Economics, Guangzhou, China
- School of Education, City University of Macau, Macao, Macao SAR, China
| | - Kecheng Chen
- School of Data Science, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yufan Wang
- Department of Industrial Engineering and Management, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yuxin Zhu
- Syns Institute of Educational Research, Hong Kong, Hong Kong SAR, China
| | - Heling Dong
- School of Physical Education, Jinan University, Guangzhou, China
| | - Zhongzhi Xu
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Weiming Chen
- Department of Health Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Weibin Cheng
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Guangzhou, China
- School of Data Science, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Fengshi Jing
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Guangzhou, China
- Faculty of Data Science, City University of Macau, Macao, Macao SAR, China
- UNC Project-China, UNC Global, School of Medicine, The University of North Carolina, Chapel Hill, NC, United States
| | - Xiaoyu Tao
- Zhuhai College of Science and Technology, Zhuhai, China
- ZCST Health and Medicine Industry Research Institute, Zhuhai, China
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Zhang C, Xu J, Tang R, Yang J, Wang W, Yu X, Shi S. Novel research and future prospects of artificial intelligence in cancer diagnosis and treatment. J Hematol Oncol 2023; 16:114. [PMID: 38012673 PMCID: PMC10680201 DOI: 10.1186/s13045-023-01514-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/20/2023] [Indexed: 11/29/2023] Open
Abstract
Research into the potential benefits of artificial intelligence for comprehending the intricate biology of cancer has grown as a result of the widespread use of deep learning and machine learning in the healthcare sector and the availability of highly specialized cancer datasets. Here, we review new artificial intelligence approaches and how they are being used in oncology. We describe how artificial intelligence might be used in the detection, prognosis, and administration of cancer treatments and introduce the use of the latest large language models such as ChatGPT in oncology clinics. We highlight artificial intelligence applications for omics data types, and we offer perspectives on how the various data types might be combined to create decision-support tools. We also evaluate the present constraints and challenges to applying artificial intelligence in precision oncology. Finally, we discuss how current challenges may be surmounted to make artificial intelligence useful in clinical settings in the future.
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Affiliation(s)
- Chaoyi Zhang
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, No. 270 Dong'An Road, Shanghai, 200032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
- Shanghai Pancreatic Cancer Institute, No. 399 Lingling Road, Shanghai, 200032, People's Republic of China
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, People's Republic of China
| | - Jin Xu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, No. 270 Dong'An Road, Shanghai, 200032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
- Shanghai Pancreatic Cancer Institute, No. 399 Lingling Road, Shanghai, 200032, People's Republic of China
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, People's Republic of China
| | - Rong Tang
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, No. 270 Dong'An Road, Shanghai, 200032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
- Shanghai Pancreatic Cancer Institute, No. 399 Lingling Road, Shanghai, 200032, People's Republic of China
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, People's Republic of China
| | - Jianhui Yang
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, No. 270 Dong'An Road, Shanghai, 200032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
- Shanghai Pancreatic Cancer Institute, No. 399 Lingling Road, Shanghai, 200032, People's Republic of China
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, People's Republic of China
| | - Wei Wang
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, No. 270 Dong'An Road, Shanghai, 200032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
- Shanghai Pancreatic Cancer Institute, No. 399 Lingling Road, Shanghai, 200032, People's Republic of China
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, People's Republic of China
| | - Xianjun Yu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, No. 270 Dong'An Road, Shanghai, 200032, People's Republic of China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China.
- Shanghai Pancreatic Cancer Institute, No. 399 Lingling Road, Shanghai, 200032, People's Republic of China.
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Si Shi
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, No. 270 Dong'An Road, Shanghai, 200032, People's Republic of China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China.
- Shanghai Pancreatic Cancer Institute, No. 399 Lingling Road, Shanghai, 200032, People's Republic of China.
- Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, People's Republic of China.
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11
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Kang CC, Lee TY, Lim WF, Yeo WWY. Opportunities and challenges of 5G network technology toward precision medicine. Clin Transl Sci 2023; 16:2078-2094. [PMID: 37702288 PMCID: PMC10651640 DOI: 10.1111/cts.13640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/14/2023] Open
Abstract
Moving away from traditional "one-size-fits-all" treatment to precision-based medicine has tremendously improved disease prognosis, accuracy of diagnosis, disease progression prediction, and targeted-treatment. The current cutting-edge of 5G network technology is enabling a growing trend in precision medicine to extend its utility and value to the smart healthcare system. The 5G network technology will bring together big data, artificial intelligence, and machine learning to provide essential levels of connectivity to enable a new health ecosystem toward precision medicine. In the 5G-enabled health ecosystem, its applications involve predictive and preventative measurements which enable advances in patient personalization. This review aims to discuss the opportunities, challenges, and prospects posed to 5G network technology in moving forward to deliver personalized treatments and patient-centric care via a precision medicine approach.
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Affiliation(s)
- Chia Chao Kang
- School of Electrical Engineering and Artificial IntelligenceXiamen University MalaysiaSepangSelangorMalaysia
| | - Tze Yan Lee
- School of Liberal Arts, Science and Technology (PUScLST)Perdana UniversityKuala LumpurMalaysia
| | - Wai Feng Lim
- Sunway Medical CentreSubang JayaSelangor Darul EhsanMalaysia
| | - Wendy Wai Yeng Yeo
- School of PharmacyMonash University MalaysiaBandar SunwaySelangor Darul EhsanMalaysia
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12
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Gandhi Z, Gurram P, Amgai B, Lekkala SP, Lokhandwala A, Manne S, Mohammed A, Koshiya H, Dewaswala N, Desai R, Bhopalwala H, Ganti S, Surani S. Artificial Intelligence and Lung Cancer: Impact on Improving Patient Outcomes. Cancers (Basel) 2023; 15:5236. [PMID: 37958411 PMCID: PMC10650618 DOI: 10.3390/cancers15215236] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Lung cancer remains one of the leading causes of cancer-related deaths worldwide, emphasizing the need for improved diagnostic and treatment approaches. In recent years, the emergence of artificial intelligence (AI) has sparked considerable interest in its potential role in lung cancer. This review aims to provide an overview of the current state of AI applications in lung cancer screening, diagnosis, and treatment. AI algorithms like machine learning, deep learning, and radiomics have shown remarkable capabilities in the detection and characterization of lung nodules, thereby aiding in accurate lung cancer screening and diagnosis. These systems can analyze various imaging modalities, such as low-dose CT scans, PET-CT imaging, and even chest radiographs, accurately identifying suspicious nodules and facilitating timely intervention. AI models have exhibited promise in utilizing biomarkers and tumor markers as supplementary screening tools, effectively enhancing the specificity and accuracy of early detection. These models can accurately distinguish between benign and malignant lung nodules, assisting radiologists in making more accurate and informed diagnostic decisions. Additionally, AI algorithms hold the potential to integrate multiple imaging modalities and clinical data, providing a more comprehensive diagnostic assessment. By utilizing high-quality data, including patient demographics, clinical history, and genetic profiles, AI models can predict treatment responses and guide the selection of optimal therapies. Notably, these models have shown considerable success in predicting the likelihood of response and recurrence following targeted therapies and optimizing radiation therapy for lung cancer patients. Implementing these AI tools in clinical practice can aid in the early diagnosis and timely management of lung cancer and potentially improve outcomes, including the mortality and morbidity of the patients.
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Affiliation(s)
- Zainab Gandhi
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes Barre, PA 18711, USA
| | - Priyatham Gurram
- Department of Medicine, Mamata Medical College, Khammam 507002, India; (P.G.); (S.P.L.); (S.M.)
| | - Birendra Amgai
- Department of Internal Medicine, Geisinger Community Medical Center, Scranton, PA 18510, USA;
| | - Sai Prasanna Lekkala
- Department of Medicine, Mamata Medical College, Khammam 507002, India; (P.G.); (S.P.L.); (S.M.)
| | - Alifya Lokhandwala
- Department of Medicine, Jawaharlal Nehru Medical College, Wardha 442001, India;
| | - Suvidha Manne
- Department of Medicine, Mamata Medical College, Khammam 507002, India; (P.G.); (S.P.L.); (S.M.)
| | - Adil Mohammed
- Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, MI 48602, USA;
| | - Hiren Koshiya
- Department of Internal Medicine, Prime West Consortium, Inglewood, CA 92395, USA;
| | - Nakeya Dewaswala
- Department of Cardiology, University of Kentucky, Lexington, KY 40536, USA;
| | - Rupak Desai
- Independent Researcher, Atlanta, GA 30079, USA;
| | - Huzaifa Bhopalwala
- Department of Internal Medicine, Appalachian Regional Hospital, Hazard, KY 41701, USA; (H.B.); (S.G.)
| | - Shyam Ganti
- Department of Internal Medicine, Appalachian Regional Hospital, Hazard, KY 41701, USA; (H.B.); (S.G.)
| | - Salim Surani
- Departmet of Pulmonary, Critical Care Medicine, Texas A&M University, College Station, TX 77845, USA;
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13
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Oehring R, Ramasetti N, Ng S, Roller R, Thomas P, Winter A, Maurer M, Moosburner S, Raschzok N, Kamali C, Pratschke J, Benzing C, Krenzien F. Use and accuracy of decision support systems using artificial intelligence for tumor diseases: a systematic review and meta-analysis. Front Oncol 2023; 13:1224347. [PMID: 37860189 PMCID: PMC10584147 DOI: 10.3389/fonc.2023.1224347] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/11/2023] [Indexed: 10/21/2023] Open
Abstract
Background For therapy planning in cancer patients multidisciplinary team meetings (MDM) are mandatory. Due to the high number of cases being discussed and significant workload of clinicians, Clinical Decision Support System (CDSS) may improve the clinical workflow. Methods This review and meta-analysis aims to provide an overview of the systems utilized and evaluate the correlation between a CDSS and MDM. Results A total of 31 studies were identified for final analysis. Analysis of different cancers shows a concordance rate (CR) of 72.7% for stage I-II and 73.4% for III-IV. For breast carcinoma, CR for stage I-II was 72.8% and for III-IV 84.1%, P≤ 0.00001. CR for colorectal carcinoma is 63% for stage I-II and 67% for III-IV, for gastric carcinoma 55% and 45%, and for lung carcinoma 85% and 83% respectively, all P>0.05. Analysis of SCLC and NSCLC yields a CR of 94,3% and 82,7%, P=0.004 and for adenocarcinoma and squamous cell carcinoma in lung cancer a CR of 90% and 86%, P=0.02. Conclusion CDSS has already been implemented in clinical practice, and while the findings suggest that its use is feasible for some cancers, further research is needed to fully evaluate its effectiveness.
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Affiliation(s)
- Robert Oehring
- Department of Surgery, Charité – Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Nikitha Ramasetti
- Department of Surgery, Charité – Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sharlyn Ng
- Department of Surgery, Charité – Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Roland Roller
- Speech and Language Technology Lab, German Research Center for Artificial Intelligence (DFKI), Berlin, Germany
| | - Philippe Thomas
- Speech and Language Technology Lab, German Research Center for Artificial Intelligence (DFKI), Berlin, Germany
| | - Axel Winter
- Department of Surgery, Charité – Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Max Maurer
- Department of Surgery, Charité – Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Simon Moosburner
- Department of Surgery, Charité – Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Nathanael Raschzok
- Department of Surgery, Charité – Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Can Kamali
- Department of Surgery, Charité – Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Johann Pratschke
- Department of Surgery, Charité – Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christian Benzing
- Department of Surgery, Charité – Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Felix Krenzien
- Department of Surgery, Charité – Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
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14
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Zhong NN, Wang HQ, Huang XY, Li ZZ, Cao LM, Huo FY, Liu B, Bu LL. Enhancing head and neck tumor management with artificial intelligence: Integration and perspectives. Semin Cancer Biol 2023; 95:52-74. [PMID: 37473825 DOI: 10.1016/j.semcancer.2023.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 07/22/2023]
Abstract
Head and neck tumors (HNTs) constitute a multifaceted ensemble of pathologies that primarily involve regions such as the oral cavity, pharynx, and nasal cavity. The intricate anatomical structure of these regions poses considerable challenges to efficacious treatment strategies. Despite the availability of myriad treatment modalities, the overall therapeutic efficacy for HNTs continues to remain subdued. In recent years, the deployment of artificial intelligence (AI) in healthcare practices has garnered noteworthy attention. AI modalities, inclusive of machine learning (ML), neural networks (NNs), and deep learning (DL), when amalgamated into the holistic management of HNTs, promise to augment the precision, safety, and efficacy of treatment regimens. The integration of AI within HNT management is intricately intertwined with domains such as medical imaging, bioinformatics, and medical robotics. This article intends to scrutinize the cutting-edge advancements and prospective applications of AI in the realm of HNTs, elucidating AI's indispensable role in prevention, diagnosis, treatment, prognostication, research, and inter-sectoral integration. The overarching objective is to stimulate scholarly discourse and invigorate insights among medical practitioners and researchers to propel further exploration, thereby facilitating superior therapeutic alternatives for patients.
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Affiliation(s)
- Nian-Nian Zhong
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Han-Qi Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Xin-Yue Huang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Zi-Zhan Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Lei-Ming Cao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Fang-Yi Huo
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Bing Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China; Department of Oral & Maxillofacial - Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China.
| | - Lin-Lin Bu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China; Department of Oral & Maxillofacial - Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China.
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15
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Han C, Pan Y, Liu C, Yang X, Li J, Wang K, Sun Z, Liu H, Jin G, Fang F, Pan X, Tang T, Chen X, Pang S, Ma L, Wang X, Ren Y, Liu M, Liu F, Jiang M, Zhao J, Lu C, Lu Z, Gao D, Jiang Z, Pei J. Assessing the decision quality of artificial intelligence and oncologists of different experience in different regions in breast cancer treatment. Front Oncol 2023; 13:1152013. [PMID: 37361565 PMCID: PMC10289408 DOI: 10.3389/fonc.2023.1152013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/26/2023] [Indexed: 06/28/2023] Open
Abstract
Background AI-based clinical decision support system (CDSS) has important prospects in overcoming the current informational challenges that cancer diseases faced, promoting the homogeneous development of standardized treatment among different geographical regions, and reforming the medical model. However, there are still a lack of relevant indicators to comprehensively assess its decision-making quality and clinical impact, which greatly limits the development of its clinical research and clinical application. This study aims to develop and application an assessment system that can comprehensively assess the decision-making quality and clinical impacts of physicians and CDSS. Methods Enrolled adjuvant treatment decision stage early breast cancer cases were randomly assigned to different decision-making physician panels (each panel consisted of three different seniority physicians in different grades hospitals), each physician made an independent "Initial Decision" and then reviewed the CDSS report online and made a "Final Decision". In addition, the CDSS and guideline expert groups independently review all cases and generate "CDSS Recommendations" and "Guideline Recommendations" respectively. Based on the design framework, a multi-level multi-indicator system including "Decision Concordance", "Calibrated Concordance", " Decision Concordance with High-level Physician", "Consensus Rate", "Decision Stability", "Guideline Conformity", and "Calibrated Conformity" were constructed. Results 531 cases containing 2124 decision points were enrolled; 27 different seniority physicians from 10 different grades hospitals have generated 6372 decision opinions before and after referring to the "CDSS Recommendations" report respectively. Overall, the calibrated decision concordance was significantly higher for CDSS and provincial-senior physicians (80.9%) than other physicians. At the same time, CDSS has a higher " decision concordance with high-level physician" (76.3%-91.5%) than all physicians. The CDSS had significantly higher guideline conformity than all decision-making physicians and less internal variation, with an overall guideline conformity variance of 17.5% (97.5% vs. 80.0%), a standard deviation variance of 6.6% (1.3% vs. 7.9%), and a mean difference variance of 7.8% (1.5% vs. 9.3%). In addition, provincial-middle seniority physicians had the highest decision stability (54.5%). The overall consensus rate among physicians was 64.2%. Conclusions There are significant internal variation in the standardization treatment level of different seniority physicians in different geographical regions in the adjuvant treatment of early breast cancer. CDSS has a higher standardization treatment level than all physicians and has the potential to provide immediate decision support to physicians and have a positive impact on standardizing physicians' treatment behaviors.
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Affiliation(s)
- Chunguang Han
- Department of Pediatric Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yubo Pan
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Breast Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chang Liu
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Breast Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaowei Yang
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Breast Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jianbin Li
- Department of Breast Cancer, Fifth Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Kun Wang
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhengkui Sun
- Department of Breast Oncology Surgery, Jiangxi Cancer Hospital (The Second People's Hospital of Jiangxi Province), Nanchang, China
| | - Hui Liu
- Department of Breast Surgery, Henan Provincial People's Hospital, Zhengzhou, China
| | - Gongsheng Jin
- Department of Oncological Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Fang Fang
- Department of Thyroid and Breast surgery, the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhhu, China
| | - Xiaofeng Pan
- Department of Thyroid and Breast surgery, the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhhu, China
| | - Tong Tang
- Department of General Surgury, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiao Chen
- Department of General Surgury, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shiyong Pang
- Department of General Surgery, Lu'an People's Hospital of Anhui Province (Lu'an Hospital of Anhui Medical University), Lu'an, China
| | - Li Ma
- Department of Thyroid and Breast Surgery, Anqing Municipal Hospital (Anqing Hospital Affiliated to Anhui Medical University), Anqing, China
| | - Xiaodong Wang
- Department of Thyroid and Breast Surgery, The people's hospital of Bozhou (Bozhou Hospital Affiliated to Anhui Medical University), Bozhou, China
| | - Yun Ren
- Department of Thyroid and Breast surgery, Department of Oncological Surgery, Taihe county people's hospital (The Taihe hospital of Wannan Medical College), Fuyang, China
| | - Mengyou Liu
- Department of Thyroid and Breast surgery, Lixin County People's Hospital, Bozhou, China
| | - Feng Liu
- Department of Breast Surgery, Fuyang Cancer Hospital, Fuyang, China
| | - Mengxue Jiang
- Department of Breast Surgery, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jiqi Zhao
- Department of Breast Surgery, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chenyang Lu
- Department of Breast Surgery, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhengdong Lu
- Department of Breast Surgery, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dongjing Gao
- Department of Breast Surgery, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zefei Jiang
- Department of Breast Cancer, Fifth Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Jing Pei
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Breast Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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16
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Ural Y, Elter T, Yilmaz Y, Hallek M, Datta RR, Kleinert R, Heidenreich A, Pfister D. Validation and implementation of a mobile app decision support system for prostate cancer to improve quality of tumor boards. PLOS DIGITAL HEALTH 2023; 2:e0000054. [PMID: 37285355 DOI: 10.1371/journal.pdig.0000054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 04/27/2023] [Indexed: 06/09/2023]
Abstract
Certified Cancer Centers must present all patients in multidisciplinary tumor boards (MTB), including standard cases with well-established treatment strategies. Too many standard cases can absorb much of the available time, which can be unfavorable for the discussion of complex cases. In any case, this leads to a high quantity, but not necessarily a high quality of tumor boards. Our aim was to develop a partially algorithm-driven decision support system (DSS) for smart phones to provide evidence-based recommendations for first-line therapy of common urological cancers. To assure quality, we compared each single digital decision with recommendations of an experienced MTB and obtained the concordance.1873 prostate cancer patients presented in the MTB of the urological department of the University Hospital of Cologne from 2014 to 2018 have been evaluated. Patient characteristics included age, disease stage, Gleason Score, PSA and previous therapies. The questions addressed to MTB were again answered using DSS. All blinded pairs of answers were assessed for discrepancies by independent reviewers. Overall concordance rate was 99.1% (1856/1873). Stage specific concordance rates were 97.4% (stage I), 99.2% (stage II), 100% (stage III), and 99.2% (stage IV). Quality of concordance were independent of age and risk profile. The reliability of any DSS is the key feature before implementation in clinical routine. Although our system appears to provide this safety, we are now performing cross-validation with several clinics to further increase decision quality and avoid potential clinic bias.
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Affiliation(s)
- Yasemin Ural
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Urology, Uro-Oncology and robot assisted surgery, Germany
| | - Thomas Elter
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Germany
| | - Yasemin Yilmaz
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Urology, Uro-Oncology and robot assisted surgery, Germany
| | - Michael Hallek
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Germany
| | - Rabi Raj Datta
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of General, Visceral, Cancer and Transplantation Surgery, Germany
| | - Robert Kleinert
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of General, Visceral, Cancer and Transplantation Surgery, Germany
| | - Axel Heidenreich
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Urology, Uro-Oncology and robot assisted surgery, Germany
| | - David Pfister
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Urology, Uro-Oncology and robot assisted surgery, Germany
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17
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Wang L, Chen X, Zhang L, Li L, Huang Y, Sun Y, Yuan X. Artificial intelligence in clinical decision support systems for oncology. Int J Med Sci 2023; 20:79-86. [PMID: 36619220 PMCID: PMC9812798 DOI: 10.7150/ijms.77205] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Artificial intelligence (AI) has been widely used in various medical fields, such as image diagnosis, pathological classification, selection of treatment schemes, and prognosis analysis. Especially in the image-aided diagnosis of tumors, the cooperation of human-computer interactions has become mature. However, the ethics of the application of AI as an emerging technology in clinical decision-making have not been fully supported, so the clinical decision support system (CDSS) based on AI technology has not fully realized human-computer interactions in clinical practice as the image-aided diagnosis system. The CDSS was currently used and promoted worldwide including Watson for Oncology, Chinese society of clinical oncology-artificial intelligence (CSCO AI) and so on. This paper summarized the applications and clarified the principle of AI in CDSS, analyzed the difficulties of AI in oncology decisions, and provided a reference scheme for the application of AI in oncology decisions in the future.
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Affiliation(s)
- Lu Wang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xinyi Chen
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Lu Zhang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Long Li
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - YongBiao Huang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yinan Sun
- Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xianglin Yuan
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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18
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Li Y, Wu X, Yang P, Jiang G, Luo Y. Machine Learning for Lung Cancer Diagnosis, Treatment, and Prognosis. GENOMICS, PROTEOMICS & BIOINFORMATICS 2022; 20:850-866. [PMID: 36462630 PMCID: PMC10025752 DOI: 10.1016/j.gpb.2022.11.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 10/03/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022]
Abstract
The recent development of imaging and sequencing technologies enables systematic advances in the clinical study of lung cancer. Meanwhile, the human mind is limited in effectively handling and fully utilizing the accumulation of such enormous amounts of data. Machine learning-based approaches play a critical role in integrating and analyzing these large and complex datasets, which have extensively characterized lung cancer through the use of different perspectives from these accrued data. In this review, we provide an overview of machine learning-based approaches that strengthen the varying aspects of lung cancer diagnosis and therapy, including early detection, auxiliary diagnosis, prognosis prediction, and immunotherapy practice. Moreover, we highlight the challenges and opportunities for future applications of machine learning in lung cancer.
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Affiliation(s)
- Yawei Li
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Xin Wu
- Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Ping Yang
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905 / Scottsdale, AZ 85259, USA
| | - Guoqian Jiang
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN 55905, USA
| | - Yuan Luo
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
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The Origin and Development of Piji Pills: An Ancient Prescription of Traditional Chinese Medicine. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9090697. [PMID: 36133786 PMCID: PMC9484890 DOI: 10.1155/2022/9090697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/03/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022]
Abstract
Objective Ancient prescriptions of traditional Chinese medicine (TCM) are an important source for innovative drug research and development, which has garnered increasing attention in recent years. Piji Pills, an ancient TCM prescription, has a long history and remarkable clinical efficacy in the treatment of digestive disorders. Thus, the purpose of this study was to explore the origin and development of Piji Pills and to discuss the potential future direction of an ancient TCM prescription. Method We analyzed the origin and development of the Piji Pills by reviewing literature records and their evolution in ancient books. We used a full-text database covering 2,090 TCM ancient books and implemented the full-text retrieval function based on Ulysses software. A full-text search was conducted using the keyword “Piji Pills” (“脾积丸” in Chinese). The results generated 128 pieces of literature from 35 ancient TCM books. In order to identify pertinent sections from the generated results, the results were proofread by two independent authors (Fudong Liu and Xiaochen Jiang) who had sufficient experience concerning ancient books. The developmental process of the Piji Pills was divided into early, late, and modern times. With the approach of statistical methods and chronological description, we manually searched, indexed, and transformed 2,090 ancient TCM books. Result From the time Piji Pills were first proposed, the records in ancient books became increasingly detailed, providing an in-depth discussion of their composition, dosage, and action mechanisms. In modern times, the research on key drugs found in Piji Pills has made a great contribution to clinical practice. However, the compound research on Piji Pills is still relatively superficial and requires further in-depth study. Conclusions In this study, statistical methods were used to chronologically clarify the developmental process of Piji Pills. We found that the Piji Pills were widely used and had a significant advantage in the treatment of digestive system diseases. In-depth knowledge mining of ancient books could potentially promote the theoretical innovation of TCM and the research of new drugs.
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Pei Q, Luo Y, Chen Y, Li J, Xie D, Ye T. Artificial intelligence in clinical applications for lung cancer: diagnosis, treatment and prognosis. Clin Chem Lab Med 2022; 60:1974-1983. [PMID: 35771735 DOI: 10.1515/cclm-2022-0291] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/17/2022] [Indexed: 12/12/2022]
Abstract
Artificial Intelligence (AI) is a branch of computer science that includes research in robotics, language recognition, image recognition, natural language processing, and expert systems. AI is poised to change medical practice, and oncology is not an exception to this trend. As the matter of fact, lung cancer has the highest morbidity and mortality worldwide. The leading cause is the complexity of associating early pulmonary nodules with neoplastic changes and numerous factors leading to strenuous treatment choice and poor prognosis. AI can effectively enhance the diagnostic efficiency of lung cancer while providing optimal treatment and evaluating prognosis, thereby reducing mortality. This review seeks to provide an overview of AI relevant to all the fields of lung cancer. We define the core concepts of AI and cover the basics of the functioning of natural language processing, image recognition, human-computer interaction and machine learning. We also discuss the most recent breakthroughs in AI technologies and their clinical application regarding diagnosis, treatment, and prognosis in lung cancer. Finally, we highlight the future challenges of AI in lung cancer and its impact on medical practice.
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Affiliation(s)
- Qin Pei
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, P.R. China
| | - Yanan Luo
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, P.R. China
| | - Yiyu Chen
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, P.R. China
| | - Jingyuan Li
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, P.R. China
| | - Dan Xie
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, P.R. China
| | - Ting Ye
- Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, P.R. China
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21
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AI and Clinical Decision Making: The Limitations and Risks of Computational Reductionism in Bowel Cancer Screening. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Advances in artificial intelligence in healthcare are frequently promoted as ‘solutions’ to improve the accuracy, safety, and quality of clinical decisions, treatments, and care. Despite some diagnostic success, however, AI systems rely on forms of reductive reasoning and computational determinism that embed problematic assumptions about clinical decision-making and clinical practice. Clinician autonomy, experience, and judgement are reduced to inputs and outputs framed as binary or multi-class classification problems benchmarked against a clinician’s capacity to identify or predict disease states. This paper examines this reductive reasoning in AI systems for colorectal cancer (CRC) to highlight their limitations and risks: (1) in AI systems themselves due to inherent biases in (a) retrospective training datasets and (b) embedded assumptions in underlying AI architectures and algorithms; (2) in the problematic and limited evaluations being conducted on AI systems prior to system integration in clinical practice; and (3) in marginalising socio-technical factors in the context-dependent interactions between clinicians, their patients, and the broader health system. The paper argues that to optimise benefits from AI systems and to avoid negative unintended consequences for clinical decision-making and patient care, there is a need for more nuanced and balanced approaches to AI system deployment and evaluation in CRC.
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22
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Morley J, Murphy L, Mishra A, Joshi I, Karpathakis K. Governing Data and Artificial Intelligence for Health Care: Developing an International Understanding. JMIR Form Res 2022; 6:e31623. [PMID: 35099403 PMCID: PMC8844981 DOI: 10.2196/31623] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 01/04/2023] Open
Abstract
Background Although advanced analytical techniques falling under the umbrella heading of artificial intelligence (AI) may improve health care, the use of AI in health raises safety and ethical concerns. There are currently no internationally recognized governance mechanisms (policies, ethical standards, evaluation, and regulation) for developing and using AI technologies in health care. A lack of international consensus creates technical and social barriers to the use of health AI while potentially hampering market competition. Objective The aim of this study is to review current health data and AI governance mechanisms being developed or used by Global Digital Health Partnership (GDHP) member countries that commissioned this research, identify commonalities and gaps in approaches, identify examples of best practices, and understand the rationale for policies. Methods Data were collected through a scoping review of academic literature and a thematic analysis of policy documents published by selected GDHP member countries. The findings from this data collection and the literature were used to inform semistructured interviews with key senior policy makers from GDHP member countries exploring their countries’ experience of AI-driven technologies in health care and associated governance and inform a focus group with professionals working in international health and technology to discuss the themes and proposed policy recommendations. Policy recommendations were developed based on the aggregated research findings. Results As this is an empirical research paper, we primarily focused on reporting the results of the interviews and the focus group. Semistructured interviews (n=10) and a focus group (n=6) revealed 4 core areas for international collaborations: leadership and oversight, a whole systems approach covering the entire AI pipeline from data collection to model deployment and use, standards and regulatory processes, and engagement with stakeholders and the public. There was a broad range of maturity in health AI activity among the participants, with varying data infrastructure, application of standards across the AI life cycle, and strategic approaches to both development and deployment. A demand for further consistency at the international level and policies was identified to support a robust innovation pipeline. In total, 13 policy recommendations were developed to support GDHP member countries in overcoming core AI governance barriers and establishing common ground for international collaboration. Conclusions AI-driven technology research and development for health care outpaces the creation of supporting AI governance globally. International collaboration and coordination on AI governance for health care is needed to ensure coherent solutions and allow countries to support and benefit from each other’s work. International bodies and initiatives have a leading role to play in the international conversation, including the production of tools and sharing of practical approaches to the use of AI-driven technologies for health care.
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Affiliation(s)
- Jessica Morley
- Oxford Internet Institute, University of Oxford, Oxford, United Kingdom
| | | | - Abhishek Mishra
- Uehiro Centre for Practical Ethics, University of Oxford, Oxford, United Kingdom
| | | | - Kassandra Karpathakis
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
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23
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Huang PH, Kim KH, Schermer M. Ethical Issues of Digital Twins for Personalized Health Care Service: Preliminary Mapping Study. J Med Internet Res 2022; 24:e33081. [PMID: 35099399 PMCID: PMC8844982 DOI: 10.2196/33081] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/27/2021] [Accepted: 11/16/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The concept of digital twins has great potential for transforming the existing health care system by making it more personalized. As a convergence of health care, artificial intelligence, and information and communication technologies, personalized health care services that are developed under the concept of digital twins raise a myriad of ethical issues. Although some of the ethical issues are known to researchers working on digital health and personalized medicine, currently, there is no comprehensive review that maps the major ethical risks of digital twins for personalized health care services. OBJECTIVE This study aims to fill the research gap by identifying the major ethical risks of digital twins for personalized health care services. We first propose a working definition for digital twins for personalized health care services to facilitate future discussions on the ethical issues related to these emerging digital health services. We then develop a process-oriented ethical map to identify the major ethical risks in each of the different data processing phases. METHODS We resorted to the literature on eHealth, personalized medicine, precision medicine, and information engineering to identify potential issues and developed a process-oriented ethical map to structure the inquiry in a more systematic way. The ethical map allows us to see how each of the major ethical concerns emerges during the process of transforming raw data into valuable information. Developers of a digital twin for personalized health care service may use this map to identify ethical risks during the development stage in a more systematic way and can proactively address them. RESULTS This paper provides a working definition of digital twins for personalized health care services by identifying 3 features that distinguish the new application from other eHealth services. On the basis of the working definition, this paper further layouts 10 major operational problems and the corresponding ethical risks. CONCLUSIONS It is challenging to address all the major ethical risks that a digital twin for a personalized health care service might encounter proactively without a conceptual map at hand. The process-oriented ethical map we propose here can assist the developers of digital twins for personalized health care services in analyzing ethical risks in a more systematic manner.
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Affiliation(s)
- Pei-Hua Huang
- Department of Medical Ethics, Philosophy and History of Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Ki-Hun Kim
- Department of Industrial Engineering, Pusan National University, Busan, Republic of Korea
| | - Maartje Schermer
- Department of Medical Ethics, Philosophy and History of Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
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Li Y, Chen D, Wu X, Yang W, Chen Y. A narrative review of artificial intelligence-assisted histopathologic diagnosis and decision-making for non-small cell lung cancer: achievements and limitations. J Thorac Dis 2022; 13:7006-7020. [PMID: 35070383 PMCID: PMC8743410 DOI: 10.21037/jtd-21-806] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 12/01/2021] [Indexed: 12/12/2022]
Abstract
Objective To summarize the current evidence regarding the applications, workflow, and limitations of artificial intelligence (AI) in the management of patients pathologically-diagnosed with lung cancer. Background Lung cancer is one of the most common cancers and the leading cause of cancer-related deaths worldwide. AI technologies have been applied to daily medical workflow and have achieved an excellent performance in predicting histopathologic subtypes, analyzing gene mutation profiles, and assisting in clinical decision-making for lung cancer treatment. More advanced deep learning for classifying pathologic images with minimal human interactions has been developed in addition to the conventional machine learning scheme. Methods Studies were identified by searching databases, including PubMed, EMBASE, Web of Science, and Cochrane Library, up to February 2021 without language restrictions. Conclusions A number of studies have evaluated AI pipelines and confirmed that AI is robust and efficacious in lung cancer diagnosis and decision-making, demonstrating that AI models are a useful tool for assisting oncologists in health management. Although several limitations that pose an obstacle for the widespread use of AI schemes persist, the unceasing refinement of AI techniques is poised to overcome such problems. Thus, AI technology is a promising tool for use in diagnosing and managing lung cancer.
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Affiliation(s)
- Yongzhong Li
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Donglai Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
| | - Xuejie Wu
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Wentao Yang
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yongbing Chen
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
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25
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Abstract
PURPOSE OF REVIEW In this article, we focus on the role of artificial intelligence in the management of lung cancer. We summarized commonly used algorithms, current applications and challenges of artificial intelligence in lung cancer. RECENT FINDINGS Feature engineering for tabular data and computer vision for image data are commonly used algorithms in lung cancer research. Furthermore, the use of artificial intelligence in lung cancer has extended to the entire clinical pathway including screening, diagnosis and treatment. Lung cancer screening mainly focuses on two aspects: identifying high-risk populations and the automatic detection of lung nodules. Artificial intelligence diagnosis of lung cancer covers imaging diagnosis, pathological diagnosis and genetic diagnosis. The artificial intelligence clinical decision-support system is the main application of artificial intelligence in lung cancer treatment. Currently, the challenges of artificial intelligence applications in lung cancer mainly focus on the interpretability of artificial intelligence models and limited annotated datasets; and recent advances in explainable machine learning, transfer learning and federated learning might solve these problems. SUMMARY Artificial intelligence shows great potential in many aspects of the management of lung cancer, especially in screening and diagnosis. Future studies on interpretability and privacy are needed for further application of artificial intelligence in lung cancer.
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Affiliation(s)
- Kai Zhang
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
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26
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Talwar V, Chufal KS, Joga S. Artificial Intelligence: A New Tool in Oncologist's Armamentarium. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1735577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
AbstractArtificial intelligence (AI) has become an essential tool in human life because of its pivotal role in communications, transportation, media, and social networking. Inspired by the complex neuronal network and its functions in human beings, AI, using computer-based algorithms and training, had been explored since the 1950s. To tackle the enormous amount of patients' clinical data, imaging, histopathological data, and the increasing pace of research on new treatments and clinical trials, and ever-changing guidelines for treatment with the advent of novel drugs and evidence, AI is the need of the hour. There are numerous publications and active work on AI's role in the field of oncology. In this review, we discuss the fundamental terminology of AI, its applications in oncology on the whole, and its limitations. There is an inter-relationship between AI, machine learning and, deep learning. The virtual branch of AI deals with machine learning. While the physical branch of AI deals with the delivery of different forms of treatment—surgery, targeted drug delivery, and elderly care. The applications of AI in oncology include cancer screening, diagnosis (clinical, imaging, and histopathological), radiation therapy (image acquisition, tumor and organs at risk segmentation, image registration, planning, and delivery), prediction of treatment outcomes and toxicities, prediction of cancer cell sensitivity to therapeutics and clinical decision-making. A specific area of interest is in the development of effective drug combinations tailored to every patient and tumor with the help of AI. Radiomics, the new kid on the block, deals with the planning and administration of radiotherapy. As with any new invention, AI has its fallacies. The limitations include lack of external validation and proof of generalizability, difficulty in data access for rare diseases, ethical and legal issues, no precise logic behind the prediction, and last but not the least, lack of education and expertise among medical professionals. A collaboration between departments of clinical oncology, bioinformatics, and data sciences can help overcome these problems in the near future.
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Affiliation(s)
- Vineet Talwar
- Department of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India
| | - Kundan Singh Chufal
- Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India
| | - Srujana Joga
- Department of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India
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27
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Xu L, Sanders L, Li K, Chow JCL. Chatbot for Health Care and Oncology Applications Using Artificial Intelligence and Machine Learning: Systematic Review. JMIR Cancer 2021; 7:e27850. [PMID: 34847056 PMCID: PMC8669585 DOI: 10.2196/27850] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/02/2021] [Accepted: 09/18/2021] [Indexed: 01/01/2023] Open
Abstract
Background Chatbot is a timely topic applied in various fields, including medicine and health care, for human-like knowledge transfer and communication. Machine learning, a subset of artificial intelligence, has been proven particularly applicable in health care, with the ability for complex dialog management and conversational flexibility. Objective This review article aims to report on the recent advances and current trends in chatbot technology in medicine. A brief historical overview, along with the developmental progress and design characteristics, is first introduced. The focus will be on cancer therapy, with in-depth discussions and examples of diagnosis, treatment, monitoring, patient support, workflow efficiency, and health promotion. In addition, this paper will explore the limitations and areas of concern, highlighting ethical, moral, security, technical, and regulatory standards and evaluation issues to explain the hesitancy in implementation. Methods A search of the literature published in the past 20 years was conducted using the IEEE Xplore, PubMed, Web of Science, Scopus, and OVID databases. The screening of chatbots was guided by the open-access Botlist directory for health care components and further divided according to the following criteria: diagnosis, treatment, monitoring, support, workflow, and health promotion. Results Even after addressing these issues and establishing the safety or efficacy of chatbots, human elements in health care will not be replaceable. Therefore, chatbots have the potential to be integrated into clinical practice by working alongside health practitioners to reduce costs, refine workflow efficiencies, and improve patient outcomes. Other applications in pandemic support, global health, and education are yet to be fully explored. Conclusions Further research and interdisciplinary collaboration could advance this technology to dramatically improve the quality of care for patients, rebalance the workload for clinicians, and revolutionize the practice of medicine.
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Affiliation(s)
- Lu Xu
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,Department of Medical Biophysics, Western University, London, ON, Canada
| | - Leslie Sanders
- Department of Humanities, York University, Toronto, ON, Canada
| | - Kay Li
- Department of English, York University, Toronto, ON, Canada
| | - James C L Chow
- Department of Medical Physics, Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
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28
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Yung A, Kay J, Beale P, Gibson KA, Shaw T. Computer-Based Decision Tools for Shared Therapeutic Decision-making in Oncology: Systematic Review. JMIR Cancer 2021; 7:e31616. [PMID: 34544680 PMCID: PMC8579220 DOI: 10.2196/31616] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Therapeutic decision-making in oncology is a complex process because physicians must consider many forms of medical data and protocols. Another challenge for physicians is to clearly communicate their decision-making process to patients to ensure informed consent. Computer-based decision tools have the potential to play a valuable role in supporting this process. OBJECTIVE This systematic review aims to investigate the extent to which computer-based decision tools have been successfully adopted in oncology consultations to improve patient-physician joint therapeutic decision-making. METHODS This review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist and guidelines. A literature search was conducted on February 4, 2021, across the Cochrane Database of Systematic Reviews (from 2005 to January 28, 2021), the Cochrane Central Register of Controlled Trials (December 2020), MEDLINE (from 1946 to February 4, 2021), Embase (from 1947 to February 4, 2021), Web of Science (from 1900 to 2021), Scopus (from 1969 to 2021), and PubMed (from 1991 to 2021). We used a snowball approach to identify additional studies by searching the reference lists of the studies included for full-text review. Additional supplementary searches of relevant journals and gray literature websites were conducted. The reviewers screened the articles eligible for review for quality and inclusion before data extraction. RESULTS There are relatively few studies looking at the use of computer-based decision tools in oncology consultations. Of the 4431 unique articles obtained from the searches, only 10 (0.22%) satisfied the selection criteria. From the 10 selected studies, 8 computer-based decision tools were identified. Of the 10 studies, 6 (60%) were conducted in the United States. Communication and information-sharing were improved between physicians and patients. However, physicians did not change their habits to take advantage of computer-assisted decision-making tools or the information they provide. On average, the use of these computer-based decision tools added approximately 5 minutes to the total length of consultations. In addition, some physicians felt that the technology increased patients' anxiety. CONCLUSIONS Of the 10 selected studies, 6 (60%) demonstrated positive outcomes, 1 (10%) showed negative results, and 3 (30%) were neutral. Adoption of computer-based decision tools during oncology consultations continues to be low. This review shows that information-sharing and communication between physicians and patients can be improved with the assistance of technology. However, the lack of integration with electronic health records is a barrier. This review provides key requirements for enhancing the chance of success of future computer-based decision tools. However, it does not show the effects of health care policies, regulations, or business administration on physicians' propensity to adopt the technology. Nevertheless, it is important that future research address the influence of these higher-level factors as well. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42021226087; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021226087.
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Affiliation(s)
- Alan Yung
- Research in Implementation Science and eHealth, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Judy Kay
- Human Centred Technology Cluster, School of Computer Science, The University of Sydney, Sydney, Australia
| | - Philip Beale
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Australia
| | - Kathryn A Gibson
- Department of Rheumatology, Liverpool Hospital, Ingham Research Institute, University of New South Wales, Sydney, Australia
| | - Tim Shaw
- Research in Implementation Science and eHealth, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sydney Catalyst Translational Cancer Research Centre, The University of Sydney, Sydney, Australia
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Holohan M, Fiske A. "Like I'm Talking to a Real Person": Exploring the Meaning of Transference for the Use and Design of AI-Based Applications in Psychotherapy. Front Psychol 2021; 12:720476. [PMID: 34646209 PMCID: PMC8502869 DOI: 10.3389/fpsyg.2021.720476] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/16/2021] [Indexed: 11/18/2022] Open
Abstract
AI-enabled virtual and robot therapy is increasingly being integrated into psychotherapeutic practice, supporting a host of emotional, cognitive, and social processes in the therapeutic encounter. Given the speed of research and development trajectories of AI-enabled applications in psychotherapy and the practice of mental healthcare, it is likely that therapeutic chatbots, avatars, and socially assistive devices will soon translate into clinical applications much more broadly. While AI applications offer many potential opportunities for psychotherapy, they also raise important ethical, social, and clinical questions that have not yet been adequately considered for clinical practice. In this article, we begin to address one of these considerations: the role of transference in the psychotherapeutic relationship. Drawing on Karen Barad’s conceptual approach to theorizing human–non-human relations, we show that the concept of transference is necessarily reconfigured within AI-human psychotherapeutic encounters. This has implications for understanding how AI-driven technologies introduce changes in the field of traditional psychotherapy and other forms of mental healthcare and how this may change clinical psychotherapeutic practice and AI development alike. As more AI-enabled apps and platforms for psychotherapy are developed, it becomes necessary to re-think AI-human interaction as more nuanced and richer than a simple exchange of information between human and nonhuman actors alone.
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Affiliation(s)
- Michael Holohan
- Institute of History and Ethics in Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Amelia Fiske
- Institute of History and Ethics in Medicine, School of Medicine, Technical University of Munich, Munich, Germany
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30
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Emani S, Rui A, Rocha HAL, Rizvi RF, Juaçaba SF, Jackson GP, Bates DW. Physician Perception and Satisfaction with Artificial Intelligence in Cancer Treatment: The Watson for Oncology Experience and Implications for Low-Middle Income Countries (Preprint). JMIR Cancer 2021; 8:e31461. [PMID: 35389353 PMCID: PMC9030908 DOI: 10.2196/31461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 01/21/2022] [Accepted: 02/08/2022] [Indexed: 12/24/2022] Open
Abstract
As technology continues to improve, health care systems have the opportunity to use a variety of innovative tools for decision-making, including artificial intelligence (AI) applications. However, there has been little research on the feasibility and efficacy of integrating AI systems into real-world clinical practice, especially from the perspectives of clinicians who use such tools. In this paper, we review physicians’ perceptions of and satisfaction with an AI tool, Watson for Oncology, which is used for the treatment of cancer. Watson for Oncology has been implemented in several different settings, including Brazil, China, India, South Korea, and Mexico. By focusing on the implementation of an AI-based clinical decision support system for oncology, we aim to demonstrate how AI can be both beneficial and challenging for cancer management globally and particularly for low-middle–income countries. By doing so, we hope to highlight the need for additional research on user experience and the unique social, cultural, and political barriers to the successful implementation of AI in low-middle–income countries for cancer care.
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Affiliation(s)
- Srinivas Emani
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
- Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, GA, United States
| | - Angela Rui
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Hermano Alexandre Lima Rocha
- Department of Community Health, Federal University of Cearrá, Fortaleza, CE, Brazil
- Instituto do Câncer do Ceará, Fortaleza, CE, Brazil
| | | | - Sergio Ferreira Juaçaba
- Instituto do Câncer do Ceará, Fortaleza, CE, Brazil
- Rodolfo Teofilo College, Fortaleza CE, Brazil
| | - Gretchen Purcell Jackson
- Intuitive Surgical, Sunnyvale, CA, United States
- Departments of Pediatric Surgery, Pediatrics, and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - David W Bates
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
- Department of Healthcare Policy and Management, Harvard School of Public Health, Boston, MA, United States
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Yin J, Ngiam KY, Teo HH. Role of Artificial Intelligence Applications in Real-Life Clinical Practice: Systematic Review. J Med Internet Res 2021; 23:e25759. [PMID: 33885365 PMCID: PMC8103304 DOI: 10.2196/25759] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Artificial intelligence (AI) applications are growing at an unprecedented pace in health care, including disease diagnosis, triage or screening, risk analysis, surgical operations, and so forth. Despite a great deal of research in the development and validation of health care AI, only few applications have been actually implemented at the frontlines of clinical practice. OBJECTIVE The objective of this study was to systematically review AI applications that have been implemented in real-life clinical practice. METHODS We conducted a literature search in PubMed, Embase, Cochrane Central, and CINAHL to identify relevant articles published between January 2010 and May 2020. We also hand searched premier computer science journals and conferences as well as registered clinical trials. Studies were included if they reported AI applications that had been implemented in real-world clinical settings. RESULTS We identified 51 relevant studies that reported the implementation and evaluation of AI applications in clinical practice, of which 13 adopted a randomized controlled trial design and eight adopted an experimental design. The AI applications targeted various clinical tasks, such as screening or triage (n=16), disease diagnosis (n=16), risk analysis (n=14), and treatment (n=7). The most commonly addressed diseases and conditions were sepsis (n=6), breast cancer (n=5), diabetic retinopathy (n=4), and polyp and adenoma (n=4). Regarding the evaluation outcomes, we found that 26 studies examined the performance of AI applications in clinical settings, 33 studies examined the effect of AI applications on clinician outcomes, 14 studies examined the effect on patient outcomes, and one study examined the economic impact associated with AI implementation. CONCLUSIONS This review indicates that research on the clinical implementation of AI applications is still at an early stage despite the great potential. More research needs to assess the benefits and challenges associated with clinical AI applications through a more rigorous methodology.
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Affiliation(s)
- Jiamin Yin
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
| | - Kee Yuan Ngiam
- Department of Surgery, National University Hospital, Singapore, Singapore
| | - Hock Hai Teo
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
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Ahmad Z, Rahim S, Zubair M, Abdul-Ghafar J. Artificial intelligence (AI) in medicine, current applications and future role with special emphasis on its potential and promise in pathology: present and future impact, obstacles including costs and acceptance among pathologists, practical and philosophical considerations. A comprehensive review. Diagn Pathol 2021; 16:24. [PMID: 33731170 PMCID: PMC7971952 DOI: 10.1186/s13000-021-01085-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/04/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The role of Artificial intelligence (AI) which is defined as the ability of computers to perform tasks that normally require human intelligence is constantly expanding. Medicine was slow to embrace AI. However, the role of AI in medicine is rapidly expanding and promises to revolutionize patient care in the coming years. In addition, it has the ability to democratize high level medical care and make it accessible to all parts of the world. MAIN TEXT Among specialties of medicine, some like radiology were relatively quick to adopt AI whereas others especially pathology (and surgical pathology in particular) are only just beginning to utilize AI. AI promises to play a major role in accurate diagnosis, prognosis and treatment of cancers. In this paper, the general principles of AI are defined first followed by a detailed discussion of its current role in medicine. In the second half of this comprehensive review, the current and future role of AI in surgical pathology is discussed in detail including an account of the practical difficulties involved and the fear of pathologists of being replaced by computer algorithms. A number of recent studies which demonstrate the usefulness of AI in the practice of surgical pathology are highlighted. CONCLUSION AI has the potential to transform the practice of surgical pathology by ensuring rapid and accurate results and enabling pathologists to focus on higher level diagnostic and consultative tasks such as integrating molecular, morphologic and clinical information to make accurate diagnosis in difficult cases, determine prognosis objectively and in this way contribute to personalized care.
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Affiliation(s)
- Zubair Ahmad
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Shabina Rahim
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Maha Zubair
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Jamshid Abdul-Ghafar
- Department of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan.
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A meta-analysis of Watson for Oncology in clinical application. Sci Rep 2021; 11:5792. [PMID: 33707577 PMCID: PMC7952578 DOI: 10.1038/s41598-021-84973-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/25/2020] [Indexed: 01/15/2023] Open
Abstract
Using the method of meta-analysis to systematically evaluate the consistency of treatment schemes between Watson for Oncology (WFO) and Multidisciplinary Team (MDT), and to provide references for the practical application of artificial intelligence clinical decision-support system in cancer treatment. We systematically searched articles about the clinical applications of Watson for Oncology in the databases and conducted meta-analysis using RevMan 5.3 software. A total of 9 studies were identified, including 2463 patients. When the MDT is consistent with WFO at the ‘Recommended’ or the ‘For consideration’ level, the overall concordance rate is 81.52%. Among them, breast cancer was the highest and gastric cancer was the lowest. The concordance rate in stage I–III cancer is higher than that in stage IV, but the result of lung cancer is opposite (P < 0.05).Similar results were obtained when MDT was only consistent with WFO at the "recommended" level. Moreover, the consistency of estrogen and progesterone receptor negative breast cancer patients, colorectal cancer patients under 70 years old or ECOG 0, and small cell lung cancer patients is higher than that of estrogen and progesterone positive breast cancer patients, colorectal cancer patients over 70 years old or ECOG 1–2, and non-small cell lung cancer patients, with statistical significance (P < 0.05). Treatment recommendations made by WFO and MDT were highly concordant for cancer cases examined, but this system still needs further improvement. Owing to relatively small sample size of the included studies, more well-designed, and large sample size studies are still needed.
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Aikemu B, Xue P, Hong H, Jia H, Wang C, Li S, Huang L, Ding X, Zhang H, Cai G, Lu A, Xie L, Li H, Zheng M, Sun J. Artificial Intelligence in Decision-Making for Colorectal Cancer Treatment Strategy: An Observational Study of Implementing Watson for Oncology in a 250-Case Cohort. Front Oncol 2021; 10:594182. [PMID: 33628729 PMCID: PMC7899045 DOI: 10.3389/fonc.2020.594182] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/21/2020] [Indexed: 12/15/2022] Open
Abstract
Background Personalized and novel evidence-based clinical treatment strategy consulting for colorectal cancer has been available through various artificial intelligence (AI) supporting systems such as Watson for Oncology (WFO) from IBM. However, the potential effects of this supporting tool in cancer care have not been thoroughly explored in real-world studies. This research aims to investigate the concordance between treatment recommendations for colorectal cancer patients made by WFO and a multidisciplinary team (MDT) at a major comprehensive gastrointestinal cancer center. Methods In this prospective study, both WFO and the blinded MDT's treatment recommendations were provided concurrently for enrolled colorectal cancers of stages II to IV between March 2017 and January 2018 at Shanghai Minimally Invasive Surgery Center. Concordance was achieved if the cancer team's decisions were listed in the "recommended" or "for consideration" classification in WFO. A review was carried out after 100 cases for all non-concordant patients to explain the inconsistency, and corresponding feedback was given to WFO's database. The concordance of the subsequent cases was analyzed to evaluate both the performance and learning ability of WFO. Results Overall, 250 patients met the inclusion criteria and were recruited in the study. Eighty-one were diagnosed with colon cancer and 189 with rectal cancer. The concordances for colon cancer, rectal cancer, or overall were all 91%. The overall rates were 83, 94, and 88% in subgroups of stages II, III, and IV. When categorized by treatment strategy, concordances were 97, 93, 89, 87, and 100% for neoadjuvant, surgery, adjuvant, first line, and second line treatment groups, respectively. After analyzing the main factors causing discordance, relative updates were made in the database accordingly, which led to the concordance curve rising in most groups compared with the initial rates. Conclusion Clinical recommendations made by WFO and the cancer team were highly matched for colorectal cancer. Patient age, cancer stage, and the consideration of previous therapy details had a significant influence on concordance. Addressing these perspectives will facilitate the use of the cancer decision-support systems to help oncologists achieve the promise of precision medicine.
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Affiliation(s)
- Batuer Aikemu
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pei Xue
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hiju Hong
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongtao Jia
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenxing Wang
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuchun Li
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ling Huang
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyi Ding
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huan Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gang Cai
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Aiguo Lu
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Xie
- Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Li
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Minhua Zheng
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Sun
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Abstract
Industrial reforms utilizing artificial intelligence (AI) have advanced remarkably in recent years. The application of AI to big data analysis in the medical information field has also been advancing and is expected to be used to find drug adverse effects that cannot be predicted by conventional methods. We have developed an adverse drug reactions analysis system that uses machine learning and data from the Japanese Adverse Drug Event Report (JADER) database. The system was developed using the C# programming language and incorporates the open source machine learning library Accord.Net. Potential analytical capabilities of the system include discovering unknown drug adverse effects and evaluating drug-induced adverse events in pharmaceutical management. However, to apply the system to pharmaceutical management, it is important to examine the characteristics and suitability of the level of AI used in the system and to select statistical methods or machine learning when appropriate. If these points are addressed, there is potential for pharmaceutical management to be individualized and optimized in the clinical setting by using the developed system to analyze big data. The system also has the potential to allow individual healthcare facilities such as hospitals and pharmacies to contribute to drug repositioning, including the discovery of new efficacies, interactions, and drug adverse events.
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Zhang W, Qi S, Zhuo J, Wen S, Fang C. Concordance Study in Hepatectomy Recommendations Between Watson for Oncology and Clinical Practice for Patients with Hepatocellular Carcinoma in China. World J Surg 2021; 44:1945-1953. [PMID: 32020325 DOI: 10.1007/s00268-020-05401-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND With the improvement in diagnostic imaging, perioperative care and surgical technique, the indications and complexity of liver resections have developed. However, the surgical indications remain controversial especially for some complex or advanced hepatocellular carcinomas. This study was designed to evaluate the concordance between hepatectomy recommendations proposed by Watson for Oncology, a cognitive technology providing decision support, and those determined by surgeons in our center for patients with hepatocellular carcinoma. METHODS We retrospectively reviewed 243 patients with hepatocellular carcinoma who were recommended for surgical treatment and received hepatectomy between 2008 and 2016 at the Zhujiang Hospital of Southern Medical University. Watson for Oncology classified the treatment options into three categories: recommended, for consideration and not recommended. Treatment recommendations were considered concordant if the hepatectomy recommendations were designated "recommended" or "for consideration" by Watson for Oncology. The factors potentially affecting concordance rate were also analyzed in our study. RESULTS The hepatectomy recommendations of 174 patients were concordant. There were significant differences in the coincidence rate between concordant group and discordant group considering tumor numbers (P = 0.006), extension of hepatectomy (P = 0.009) and BCLC staging system (P < 0.001). Lower degrees of concordance were observed in patients with multiple tumors, major hepatectomy and portal hypertension by using logistic regression analysis (OR = 0.309, P = 0.004; OR = 0.384, P = 0.004; and OR = 0.376, P = 0.022, respectively). CONCLUSION The concordance between Watson for Oncology and surgeons' hepatectomy recommendation for hepatocellular carcinoma was only 72%. Differences in practice patterns for HCC between the USA (where Watson for Oncology was calibrated) and China may be the major cause of discordance. Watson for Oncology still requires further improvement and localization to be widely applied in China.
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Affiliation(s)
- Weiqi Zhang
- Guangdong Provincial Clinical and Engineering Center of Digital Medicine, The First Department of Hepatobiliary Surgery Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Shuo Qi
- Guangdong Provincial Clinical and Engineering Center of Digital Medicine, The First Department of Hepatobiliary Surgery Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Jiaming Zhuo
- Guangdong Provincial Clinical and Engineering Center of Digital Medicine, The First Department of Hepatobiliary Surgery Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Sai Wen
- Guangdong Provincial Clinical and Engineering Center of Digital Medicine, The First Department of Hepatobiliary Surgery Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Chihua Fang
- Guangdong Provincial Clinical and Engineering Center of Digital Medicine, The First Department of Hepatobiliary Surgery Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China.
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Zhou J, Zeng ZY, Li L. Progress of Artificial Intelligence in Gynecological Malignant Tumors. Cancer Manag Res 2020; 12:12823-12840. [PMID: 33364831 PMCID: PMC7751777 DOI: 10.2147/cmar.s279990] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/22/2020] [Indexed: 12/12/2022] Open
Abstract
Artificial intelligence (AI) is a sort of new technical science which can simulate, extend and expand human intelligence by developing theories, methods and application systems. In the last five years, the application of AI in medical research has become a hot topic in modern science and technology. Gynecological malignant tumors involves a wide range of knowledge, and AI can play an important part in these aspects, such as medical image recognition, auxiliary diagnosis, drug research and development, treatment scheme formulation and other fields. The purpose of this paper is to describe the progress of AI in gynecological malignant tumors and discuss some problems in its application. It is believed that AI improves the efficiency of diagnosis, reduces the burden of clinicians, and improves the effect of treatment and prognosis. AI will play an irreplaceable role in the field of gynecological malignant oncology and will promote the development of medicine and further promote the transformation from traditional medicine to precision medicine and preventive medicine. However, there are also some problems in the application of AI in gynecologic malignant tumors. For example, AI, inseparable from human participation, still needs to be more “humanized”, and needs to further protect patients’ privacy and health, improve legal and insurance protection, and further improve according to local ethnic conditions and national conditions. However, it is believed that with the continuous development of AI, especially ensemble classifier, and deep learning will have a profound influence on the future of medical technology, which is a powerful driving force for future medical innovation and reform.
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Affiliation(s)
- Jie Zhou
- Department of Gynecologic Oncology, Guangxi Medical University Cancer Hospital, Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Ministry of Education, Nanning 530021, Guangxi, People's Republic of China.,Department of Gynecology, The Second Affiliated Hospital, University of South China, Hengyang 421001, Hunan, People's Republic of China
| | - Zhi Ying Zeng
- Department of Anesthesiology, The Second Affiliated Hospital, University of South China, Hengyang 421001, Hunan, People's Republic of China
| | - Li Li
- Department of Gynecologic Oncology, Guangxi Medical University Cancer Hospital, Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Ministry of Education, Nanning 530021, Guangxi, People's Republic of China
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When Artificial Intelligence Disagrees With the Doctor, Who's Right? The Answer Might Not Be So Evident. Dis Colon Rectum 2020; 63:1347-1349. [PMID: 32969874 DOI: 10.1097/dcr.0000000000001783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Zhao X, Zhang Y, Ma X, Chen Y, Xi J, Yin X, Kang H, Guan H, Dai Z, Liu D, Zhao F, Sun C, Li Z, Zhang S. Concordance between treatment recommendations provided by IBM Watson for Oncology and a multidisciplinary tumor board for breast cancer in China. Jpn J Clin Oncol 2020; 50:852-858. [PMID: 32419014 DOI: 10.1093/jjco/hyaa051] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/06/2020] [Accepted: 03/31/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Watson for Oncology (WFO), an artificial intelligence from IBM Corporation, can provide a treatment plan by analyzing patient's disease characteristics. The present study was performed to examine the concordance between treatment recommendations proposed by WFO and the multidisciplinary tumor board at our center. The aim was to explore the feasibility of using WFO for breast cancer cases in China and to ascertain the ways to make WFO more suitable for Chinese patients with breast cancer. METHODS Data from 302 breast cancer patients treated at the Second Affiliated Hospital of Xi'an Jiaotong University between October 2016 and February 2018 was retrieved and retrospectively analyzed by WFO. The recommendations were divided into 'recommended', 'considered' and 'not recommended' groups. Results were considered concordant when oncologists' recommendations were categorized as 'recommended' or 'for consideration' by WFO. RESULTS The concordance rate of 200 subjects with postoperative adjuvant therapy was 77%. However, the rate was 27.5% in the remaining 102 cases with metastatic disease receiving either first-line or no treatment. Further analysis demonstrated that inconsistencies were mainly due to different choices of chemotherapy regimens. Subgroup study indicates that tumor stage, receptor status and age also had influences at the concordance rate. CONCLUSION The results of this study suggest that WFO is a promising artificial intelligence system for the treatment of breast cancer. These findings can also serve as a reference framework for the inclusion of artificial intelligence in the ongoing medical reform in China.
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Affiliation(s)
- Xiaoyao Zhao
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yinbin Zhang
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xingcong Ma
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yinxi Chen
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Junfeng Xi
- Department of Thoracic surgery, Yulin City First Hospital Yulin Branch, Yulin, Shaanxi, China
| | - Xiaoran Yin
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Huafeng Kang
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Haitao Guan
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zijun Dai
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Di Liu
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Fang Zhao
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chu Sun
- Medical Advisory Department, Hangzhou cognitive Network tech Co, Ltd., Hangzhou, Zhejiang, China
| | - Zongfang Li
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shuqun Zhang
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Fischer I, Steiger HJ. Toward automatic evaluation of medical abstracts: The current value of sentiment analysis and machine learning for classification of the importance of PubMed abstracts of randomized trials for stroke. J Stroke Cerebrovasc Dis 2020; 29:105042. [PMID: 32807454 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/24/2020] [Accepted: 06/07/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Text mining with automatic extraction of key features is gaining increasing importance in science and particularly medicine due to the rapidly increasing number of publications. OBJECTIVES Here we evaluate the current potential of sentiment analysis and machine learning to extract the importance of the reported results and conclusions of randomized trials on stroke. METHODS PubMed abstracts of 200 recent reports of randomized trials were reviewed and manually classified according to the estimated importance of the studies. Importance of the papers was classified as "game changer", "suggestive", "maybe" "negative result". Algorithmic sentiment analysis was subsequently used on both the "Results" and the "Conclusions" paragraphs, resulting in a numerical output for polarity and subjectivity. The result of the human assessment was then compared to polarity and subjectivity. In addition, a neural network using the Keras platform built on Tensorflow and Python was trained to map the "Results" and "Conclusions" to the dichotomized human assessment (1: "game changer" or "suggestive"; 0:"maybe" or "negative", or no results reported). 120 abstracts were used as the training set and 80 as the test set. RESULTS 9 out of the 200 reports were classified manually as "game changer", 40 as "suggestive", 73 as "maybe" and 32 and "negative"; 46 abstracts did not contain any results. Polarity was generally higher for the "Conclusions" than for the "Results". Polarity was highest for the "Conclusions" classified as "suggestive". Subjectivity was also higher in the classes "suggestive" and "maybe" than in the classes "game changer" and "negative". The trained neural network provided a correct dichotomized output with an accuracy of 71% based on the "Results" and 73% based on "Conclusions" . CONCLUSIONS Current statistical approaches to text analysis can grasp the impact of scientific medical abstracts to a certain degree. Sentiment analysis showed that mediocre results are apparently written in more enthusiastic words than clearly positive or negative results.
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Affiliation(s)
- Igor Fischer
- Division of Informatics and Statistics, Department of Neurosurgery, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
| | - Hans-Jakob Steiger
- Clinical Division and Administration, Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.
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Liang G, Fan W, Luo H, Zhu X. The emerging roles of artificial intelligence in cancer drug development and precision therapy. Biomed Pharmacother 2020; 128:110255. [DOI: 10.1016/j.biopha.2020.110255] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/22/2020] [Accepted: 05/10/2020] [Indexed: 12/12/2022] Open
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Abstract
Lung cancer is the most common cause of cancer mortality globally. A vast majority of lung cancer cases are diagnosed at advanced stages. Management of advanced lung cancer requires several diagnostic and therapeutic procedures provided by various specialists. To optimise the entire diagnostic and therapeutic process, a concept of care provided simultaneously by a multidisciplinary team (MDT) has been developed and implemented in specialised centres worldwide. Observational studies suggest that integrated and coordinated care increases adherence to clinical guidelines, significantly shortens the interval from diagnosis to treatment, and may increase survival and quality of life (QoL). Prospective studies are warranted to assess the real impact of MDT on treatment outcomes and to further refine this approach.
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Affiliation(s)
- Anna Kowalczyk
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
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Kim MS, Park HY, Kho BG, Park CK, Oh IJ, Kim YC, Kim S, Yun JS, Song SY, Na KJ, Jeong JU, Yoon MS, Ahn SJ, Yoo SW, Kang SR, Kwon SY, Bom HS, Jang WY, Kim IY, Lee JE, Jeong WG, Kim YH, Lee T, Choi YD. Artificial intelligence and lung cancer treatment decision: agreement with recommendation of multidisciplinary tumor board. Transl Lung Cancer Res 2020; 9:507-514. [PMID: 32676314 PMCID: PMC7354125 DOI: 10.21037/tlcr.2020.04.11] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background IBM Watson for Oncology (WFO) is a cognitive computing system helping physicians quickly identify key information in a patient’s medical record, surface relevant evidence, and explore treatment options. This study assessed the possibility of using WFO for clinical treatment in lung cancer patients. Methods We evaluated the level of agreement between WFO and multidisciplinary team (MDT) for lung cancer. From January to December 2018, newly diagnosed lung cancer cases in Chonnam National University Hwasun Hospital were retrospectively examined using WFO version 18.4 according to four treatment categories (surgery, radiotherapy, chemoradiotherapy, and palliative care). Treatment recommendations were considered concordant if the MDT recommendations were designated ‘recommended’ by WFO. Concordance between MDT and WFO was analyzed by Cohen’s kappa value. Results In total, 405 (male 340, female 65) cases with different histology (adenocarcinoma 157, squamous cell carcinoma 132, small cell carcinoma 94, others 22 cases) were enrolled. Concordance between MDT and WFO occurred in 92.4% (k=0.881, P<0.001) of all cases, and concordance differed according to clinical stages. The strength of agreement was very good in stage IV non-small cell lung carcinoma (NSCLC) (100%, k=1.000) and extensive disease small cell lung carcinoma (SCLC) (100%, k=1.000). In stage I NSCLC, the agreement strength was good (92.4%, k=0.855). The concordance was moderate in stage III NSCLC (80.8%, k=0.622) and relatively low in stage II NSCLC (83.3%, k=0.556) and limited disease SCLC (84.6%, k=0.435). There were discordant cases in surgery (7/57, 12.3%), radiotherapy (2/12, 16.7%), and chemoradiotherapy (15/129, 11.6%), but no discordance in metastatic disease patients. Conclusions Treatment recommendations made by WFO and MDT were highly concordant for lung cancer cases especially in metastatic stage. However, WFO was just an assisting tool in stage I–III NSCLC and limited disease SCLC; so, patient-doctor relationship and shared decision making may be more important in this stage.
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Affiliation(s)
- Min-Seok Kim
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ha-Young Park
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Bo-Gun Kho
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Cheol-Kyu Park
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - In-Jae Oh
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Young-Chul Kim
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seok Kim
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Thoracic Surgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Sik Yun
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Thoracic Surgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sang-Yun Song
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Thoracic Surgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Kook-Joo Na
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Thoracic Surgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Uk Jeong
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Mee Sun Yoon
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Ja Ahn
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Su Woong Yoo
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sae-Ryung Kang
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seong Young Kwon
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hee-Seung Bom
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Woo-Youl Jang
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Neurosurgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - In-Young Kim
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Neurosurgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jong-Eun Lee
- Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Won-Gi Jeong
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Yun-Hyeon Kim
- Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Taebum Lee
- Department of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Yoo-Duk Choi
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea
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Shekarriz J, Keck T, Shekarriz H. Computerized Medical Evidence-Based Decision Assistance System "MEBDAS®" improves in-hospital outcome after pancreatoduodenectomy for pancreatic cancer. Pancreatology 2020; 20:746-750. [PMID: 32312611 DOI: 10.1016/j.pan.2020.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 02/02/2020] [Accepted: 04/08/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Indication for pancreatoduodenectomy for pancreatic cancer can be challenging. Wrong decisions in indication processes lead to significant health impairments. Computerized decision support systems can take over parts of decision-making processes, making them more accurate. MEBDAS® is a decision-supporting software that predicts outcomes of proposed treatments. AIM to determine the decision concordance between MEBDAS® and multidisciplinary tumour board (MTB) and the impact of MEBDAS® on in-hospital outcome at different indication thresholds. METHODS 126 patients with pancreatoduodenectomy from a high-volume university hospital were included. Outcome indicators were in-hospital mortality, Comprehensive Complication Index (CCI®), therapy-related loss of "Quality-Adjusted-Life-Day" (QALD-loss) and prognostic gain of treatment-related "Quality-Adjusted-Life-Year" (QALY-gain). RESULTS The concordance of decisions was 94.4% at the indication threshold of 0. By raising the indication threshold to 1 year, the concordance decreased to 0%, the in-hospital-mortality dropped from 2.52% to 0%, the CCI® decreased from 26.47 to 13.90, the therapy-related QALD-loss declined from 21.53 to 16.22 days and the prognostic QALY-gain increased from 0.374 to 0.906 years. At IT = 0.250 years, the concordance was 61.11% and differences between MTB and MEBDAS®-group were highly significant (p < 0.001) for all outcome parameters: mortality (3.97% vs. 1.30%), CCI® (28.96 vs. 18.29), therapy-related QALD-loss (24.41 vs. 15.19 days) and QALY-gain (0.351 vs. 0.501 years). CONCLUSION MEBDAS® decisions are superior to those of MTB in terms of in-hospital-outcome. The inclusion of MEBDAS® in decision procedure makes the indication more accurate and reduces morbidity and mortality. In addition, MEBDAS® can increase patients' competence by involving them in decision-making process.
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Affiliation(s)
- J Shekarriz
- Department of Surgery, University Hospital Schleswig-Holstein Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
| | - T Keck
- Department of Surgery, University Hospital Schleswig-Holstein Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany
| | - H Shekarriz
- University of Luebeck, Ratzeburger Allee 160, 23568, Luebeck, Germany
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Triberti S, Durosini I, Pravettoni G. A "Third Wheel" Effect in Health Decision Making Involving Artificial Entities: A Psychological Perspective. Front Public Health 2020; 8:117. [PMID: 32411641 PMCID: PMC7199477 DOI: 10.3389/fpubh.2020.00117] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/23/2020] [Indexed: 12/21/2022] Open
Abstract
In the near future, Artificial Intelligence (AI) is expected to participate more and more in decision making processes, in contexts ranging from healthcare to politics. For example, in the healthcare context, doctors will increasingly use AI and machine learning devices to improve precision in diagnosis and to identify therapy regimens. One hot topic regards the necessity for health professionals to adapt shared decision making with patients to include the contribution of AI into clinical practice, such as acting as mediators between the patient with his or her healthcare needs and the recommendations coming from artificial entities. In this scenario, a "third wheel" effect may intervene, potentially affecting the effectiveness of shared decision making in three different ways: first, clinical decisions could be delayed or paralyzed when AI recommendations are difficult to understand or to explain to patients; second, patients' symptomatology and medical diagnosis could be misinterpreted when adapting them to AI classifications; third, there may be confusion about the roles and responsibilities of the protagonists in the healthcare process (e.g., Who really has authority?). This contribution delineates such effects and tries to identify the impact of AI technology on the healthcare process, with a focus on future medical practice.
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Affiliation(s)
- Stefano Triberti
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Ilaria Durosini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Zou FW, Tang YF, Liu CY, Ma JA, Hu CH. Concordance Study Between IBM Watson for Oncology and Real Clinical Practice for Cervical Cancer Patients in China: A Retrospective Analysis. Front Genet 2020; 11:200. [PMID: 32265980 PMCID: PMC7105853 DOI: 10.3389/fgene.2020.00200] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 02/20/2020] [Indexed: 01/01/2023] Open
Abstract
Watson for Oncology (WFO) is a artificial intelligence clinical decision-support system with evidence-based treatment options for oncologists. WFO has been gradually used in China, but limited reports on whether WFO is suitable for Chinese patients. This study aims to investigate the concordance of treatment options between WFO and real clinical practice for Cervical cancer patients retrospectively. We retrospectively enrolled 300 cases of cervical cancer patients. WFO provides treatment options for 246 supported cases. Real clinical practice were defined as concordant if treatment options were designated "recommended" or "for consideration" by WFO. Concordance of treatment option between WFO and real clinical practice was analyzed statistically. The treatment concordance between WFO and real clinical practice occurred in 72.8% (179/246) of cervical cancer cases. Logistic regression analysis showed that rural registration residences, advanced age, poor ECOG performance status, stages II-IV disease have a remarkable impact on consistency. The main reasons attributed to the 27.2% (67/246) of the discordant cases were the substitution of nedaplatin for cisplatin, reimbursement plan of bevacizumab, surgical preference, and absence of neoadjuvant/adjuvant chemotherapy and PD-1/PD-L1 antibodies recommendations. WFO recommendations were in 72.8% of concordant with real clinical practice for cervical cancer patients in China. However, several localization and individual factors limit its wider application. So, WFO could be an essential tool but it cannot currently replace oncologists. To be rapidly and fully apply to cervical cancer patients in China, accelerate localization and improvement were needed for WFO.
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Affiliation(s)
- Fang-Wen Zou
- Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yi-Fang Tang
- Department of Anesthesiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chao-Yuan Liu
- Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jin-An Ma
- Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chun-Hong Hu
- Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, China
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Yao S, Wang R, Qian K, Zhang Y. Real world study for the concordance between IBM Watson for Oncology and clinical practice in advanced non-small cell lung cancer patients at a lung cancer center in China. Thorac Cancer 2020; 11:1265-1270. [PMID: 32191394 PMCID: PMC7180560 DOI: 10.1111/1759-7714.13391] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 01/15/2023] Open
Abstract
Background IBM Watson for Oncology (WFO) provides physicians with evidence‐based treatment options. This study was designed to explore the concordance of the suggested therapeutic regimen for advanced non‐small cell lung (NSCLC) cancer patients between the updated version of WFO and physicians in our department, in order to reflect the differences of cancer treatment between China and the United States. Methods Retrospective data from 165 patients with advanced NSCLC from September 2014 to March 2018 were entered manually into WFO. WFO recommendations were provided in three categories: recommended, for consideration, and not recommended. Concordance was analyzed by comparing the treatment decisions proposed by WFO with the real treatment. Potential influenced factors were also analyzed. Results Overall, the treatment recommendations were concordant in 73.3% (121/165) of cases. When two alternative drugs such as icotinib and nedaplatin were included as “for consideration,” the total consistency could be elevated from 73.3% to 90.3%(149/165). The logistic regression analysis showed that gender (P = 0.096), ECOG (P = 0.0.502), smoking (P = 0.455), and pathology (P = 0.633) had no effect on consistency, but stages (P = 0.019), including stage ≤III (77.8%, 21/27) and stage IV (93.5%, 129/138) had significant effects on consistency. Conclusions In China, most of the treatment recommendations of WFO are consistent with the real world treatment. Factors such as patient preferences, prices, drug approval and medical insurance are also taken into consideration, and they ultimately affect the inconsistency. To be comprehensively and rapidly applied in China, localization needs to be accelerated by WFO.
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Affiliation(s)
- Shuyang Yao
- Department of thoracic surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ruotian Wang
- Department of thoracic surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kun Qian
- Department of thoracic surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yi Zhang
- Department of thoracic surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
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You HS, Gao CX, Wang HB, Luo SS, Chen SY, Dong YL, Lyu J, Tian T. Concordance of Treatment Recommendations for Metastatic Non-Small-Cell Lung Cancer Between Watson for Oncology System and Medical Team. Cancer Manag Res 2020; 12:1947-1958. [PMID: 32214852 PMCID: PMC7083631 DOI: 10.2147/cmar.s244932] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 02/26/2020] [Indexed: 12/23/2022] Open
Abstract
Objective The disease complexity of metastatic non-small-cell lung cancer (mNSCLC) makes it difficult for physicians to make clinical decisions efficiently and accurately. The Watson for Oncology (WFO) system of artificial intelligence might help physicians by providing fast and precise treatment regimens. This study measured the concordance of the medical treatment regimens of the WFO system and actual clinical regimens, with the aim of determining the suitability of WFO recommendations for Chinese patients with mNSCLC. Methods Retrospective data of mNSCLC patients were input to the WFO, which generated a treatment regimen (WFO regimen). The actual regimen was made by physicians in a medical team for patients (medical-team regimen). The factors influencing the consistency of the two treatment options were analyzed by univariate and multivariate analyses. Results The concordance rate was 85.16% between the WFO and medical-team regimens for mNSCLC patients. Logistic regression showed that the concordance differed significantly for various pathological types and gene mutations in two treatment regimens. Patients with adenocarcinoma had a lower rate of “recommended” regimen than those with squamous cell carcinoma. There was a statistically significant difference in EGFR-mutant patients for “not recommended” regimens with inconsistency rate of 18.75%. In conclusion, the WFO regimen has 85.16% consistency rate with medical-team regimen in our treatment center. The different pathological type and different gene mutation markedly influenced the agreement rate of the two treatment regimens. Conclusion WFO recommendations have high applicability to mNSCLC patients in our hospital. This study demonstrates that the valuable WFO system may assist the doctors better to determine the accurate and effective treatment regimens for mNSCLC patients in the Chinese medical setting.
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Affiliation(s)
- Hai-Sheng You
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Chun-Xia Gao
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Hai-Bin Wang
- Hangzhou Cognitive N&T. Co., Ltd, Hangzhou, Zhengjiang, People's Republic of China
| | - Sai-Sai Luo
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Si-Ying Chen
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Ya-Lin Dong
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Jun Lyu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Tao Tian
- Department of Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
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Tian Y, Liu X, Wang Z, Cao S, Liu Z, Ji Q, Li Z, Sun Y, Zhou X, Wang D, Zhou Y. Concordance Between Watson for Oncology and a Multidisciplinary Clinical Decision-Making Team for Gastric Cancer and the Prognostic Implications: Retrospective Study. J Med Internet Res 2020; 22:e14122. [PMID: 32130123 PMCID: PMC7059081 DOI: 10.2196/14122] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 10/20/2019] [Accepted: 12/16/2019] [Indexed: 12/12/2022] Open
Abstract
Background With the increasing number of cancer treatments, the emergence of multidisciplinary teams (MDTs) provides patients with personalized treatment options. In recent years, artificial intelligence (AI) has developed rapidly in the medical field. There has been a gradual tendency to replace traditional diagnosis and treatment with AI. IBM Watson for Oncology (WFO) has been proven to be useful for decision-making in breast cancer and lung cancer, but to date, research on gastric cancer is limited. Objective This study compared the concordance of WFO with MDT and investigated the impact on patient prognosis. Methods This study retrospectively analyzed eligible patients (N=235) with gastric cancer who were evaluated by an MDT, received corresponding recommended treatment, and underwent follow-up. Thereafter, physicians inputted the information of all patients into WFO manually, and the results were compared with the treatment programs recommended by the MDT. If the MDT treatment program was classified as “recommended” or “considered” by WFO, we considered the results concordant. All patients were divided into a concordant group and a nonconcordant group according to whether the WFO and MDT treatment programs were concordant. The prognoses of the two groups were analyzed. Results The overall concordance of WFO and the MDT was 54.5% (128/235) in this study. The subgroup analysis found that concordance was less likely in patients with human epidermal growth factor receptor 2 (HER2)-positive tumors than in patients with HER2-negative tumors (P=.02). Age, Eastern Cooperative Oncology Group performance status, differentiation type, and clinical stage were not found to affect concordance. Among all patients, the survival time was significantly better in concordant patients than in nonconcordant patients (P<.001). Multivariate analysis revealed that concordance was an independent prognostic factor of overall survival in patients with gastric cancer (hazard ratio 0.312 [95% CI 0.187-0.521]). Conclusions The treatment recommendations made by WFO and the MDT were mostly concordant in gastric cancer patients. If the WFO options are updated to include local treatment programs, the concordance will greatly improve. The HER2 status of patients with gastric cancer had a strong effect on the likelihood of concordance. Generally, survival was better in concordant patients than in nonconcordant patients.
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Affiliation(s)
- Yulong Tian
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Xiaodong Liu
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Zixuan Wang
- Department of Endocrinology, Weifang People's Hospital, Weifang, China
| | - Shougen Cao
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Zimin Liu
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Qinglian Ji
- Department of Imaging, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Zequn Li
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Yuqi Sun
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Xin Zhou
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Daosheng Wang
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Yanbing Zhou
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
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Liu C, Zhao L, Wu F, Feng Y, Jiang R, Hu C. The multidisciplinary team plays an important role in the prediction of small solitary pulmonary nodules: a propensity-score-matching study. ANNALS OF TRANSLATIONAL MEDICINE 2020; 7:740. [PMID: 32042756 DOI: 10.21037/atm.2019.11.125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background According to guidelines, it is recommended that pulmonary nodules be discussed by a multidisciplinary team (MDT); however, the evidence for the effectiveness of MDT is sparse. To demonstrate the importance of the involvement of an MDT for the prediction of small solitary pulmonary nodules, we conducted this retrospective study. Methods The patient database of those who attended our MDT and the electronic medical record system of our hospital was used; we collected all the data from patients found with small solitary pulmonary nodules (≤2 cm), which were suspected as malignant and who received a resection of the nodules. We summarized their characteristics and analyzed them, and then compared the post-operation pathological diagnosis of the patients who attended an MDT to those who did not participate in an MDT during the same period (2017-2019.2). We also collected the follow-up data. Propensity-score-matching was utilized during the process of analysis to get a more reliable conclusion. Results Most of the qualified patients were female. Most of the small solitary pulmonary nodules (≤2 cm) were adenocarcinoma and located on the right upper lobe. There were no differences in the SUV value between malignant nodules and benign nodules. After propensity-score matching, the total positive prediction value of small solitary pulmonary nodules (≤2 cm) without an MDT was 69.4%, while that with MDT was 77.6%; the difference was not significant with a P value of 0.30. The negative predictive value of MDT was 76.2%. Conclusions In developing countries, small solitary pulmonary nodules tend to be more correctly diagnosed with MDT.
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Affiliation(s)
- Chaoyuan Liu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Lishu Zhao
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Fang Wu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Yeqian Feng
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Rong Jiang
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Chunhong Hu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha 410011, China
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