Machine learning in patient flow: a review

The Role of AI in Hospitals and Clinics: Transforming Healthcare in the 21st Century

As healthcare systems around the world face challenges such as escalating costs, limited access, and growing demand for personalized care, artificial intelligence (AI) is emerging as a key force for transformation. This review is motivated by the urgent need to harness AI's potential to mitigate these issues and aims to critically assess AI's integration in different healthcare domains. We explore how AI empowers clinical decision-making, optimizes hospital operation and management, refines medical image analysis, and revolutionizes patient care and monitoring through AI-powered wearables. Through several case studies, we review how AI has transformed specific healthcare domains and discuss the remaining challenges and possible solutions. Additionally, we will discuss methodologies for assessing AI healthcare solutions, ethical challenges of AI deployment, and the importance of data privacy and bias mitigation for responsible technology use. By presenting a critical assessment of AI's transformative potential, this review equips researchers with a deeper understanding of AI's current and future impact on healthcare. It encourages an interdisciplinary dialogue between researchers, clinicians, and technologists to navigate the complexities of AI implementation, fostering the development of AI-driven solutions that prioritize ethical standards, equity, and a patient-centered approach.

Regression-Based Machine Learning for Predicting Lifting Movement Pattern Change in People with Low Back Pain

Machine learning (ML) algorithms are crucial within the realm of healthcare applications. However, a comprehensive assessment of the effectiveness of regression algorithms in predicting alterations in lifting movement patterns has not been conducted. This research represents a pilot investigation using regression-based machine learning techniques to forecast alterations in trunk, hip, and knee movements subsequent to a 12-week strength training for people who have low back pain (LBP). The system uses a feature extraction algorithm to calculate the range of motion in the sagittal plane for the knee, trunk, and hip and 12 different regression machine learning algorithms. The results show that Ensemble Tree with LSBoost demonstrated the utmost accuracy in prognosticating trunk movement. Meanwhile, the Ensemble Tree approach, specifically LSBoost, exhibited the highest predictive precision for hip movement. The Gaussian regression with the kernel chosen as exponential returned the highest prediction accuracy for knee movement. These regression models hold the potential to significantly enhance the precision of visualisation of the treatment output for individuals afflicted with LBP.

Clinical Artificial Intelligence: Design Principles and Fallacies

Clinical artificial intelligence (AI)/machine learning (ML) is anticipated to offer new abilities in clinical decision support, diagnostic reasoning, precision medicine, clinical operational support, and clinical research, but careful concern is needed to ensure these technologies work effectively in the clinic. Here, we detail the clinical ML/AI design process, identifying several key questions and detailing several common forms of issues that arise with ML tools, as motivated by real-world examples, such that clinicians and researchers can better anticipate and correct for such issues in their own use of ML/AI techniques.

Prospective and external validation of stroke discharge planning machine learning models

Machine learning may be able to help with predicting factors that aid in discharge planning for stroke patients. This study aims to validate previously derived models, on external and prospective datasets, for the prediction of discharge modified Rankin scale (mRS), discharge destination, survival to discharge and length of stay. Data were collected from consecutive patients admitted with ischaemic or haemorrhagic stroke at the Royal Adelaide Hospital from September 2019 to January 2020, and at the Lyell McEwin Hospital from January 2017 to January 2020. The previously derived models were then applied to these datasets with three pre-defined cut-off scores (high-sensitivity, Youden's index, and high-specificity) to return indicators of performance including area under the receiver operator curve (AUC), sensitivity and specificity. The number of individuals included in the prospective and external datasets were 334 and 824 respectively. The models performed well on both the prospective and external datasets in the prediction of discharge mRS ≤ 2 (AUC 0.85 and 0.87), discharge destination to home (AUC 0.76 and 0.78) and survival to discharge (AUC 0.91 and 0.92). Accurate prediction of length of stay with only admission data remains difficult (AUC 0.62 and 0.66). This study demonstrates successful prospective and external validation of machine learning models using six variables to predict information relevant to discharge planning for stroke patients. Further research is required to demonstrate patient or system benefits following implementation of these models.