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Dundaru-Bandi D, Antel R, Ingelmo P. Advances in pediatric perioperative care using artificial intelligence. Curr Opin Anaesthesiol 2024; 37:251-258. [PMID: 38441085 DOI: 10.1097/aco.0000000000001368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE OF THIS REVIEW This article explores how artificial intelligence (AI) can be used to evaluate risks in pediatric perioperative care. It will also describe potential future applications of AI, such as models for airway device selection, controlling anesthetic depth and nociception during surgery, and contributing to the training of pediatric anesthesia providers. RECENT FINDINGS The use of AI in healthcare has increased in recent years, largely due to the accessibility of large datasets, such as those gathered from electronic health records. Although there has been less focus on pediatric anesthesia compared to adult anesthesia, research is on- going, especially for applications focused on risk factor identification for adverse perioperative events. Despite these advances, the lack of formal external validation or feasibility testing results in uncertainty surrounding the clinical applicability of these tools. SUMMARY The goal of using AI in pediatric anesthesia is to assist clinicians in providing safe and efficient care. Given that children are a vulnerable population, it is crucial to ensure that both clinicians and families have confidence in the clinical tools used to inform medical decision- making. While not yet a reality, the eventual incorporation of AI-based tools holds great potential to contribute to the safe and efficient care of our patients.
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Affiliation(s)
| | - Ryan Antel
- Department of Anesthesia, McGill University
| | - Pablo Ingelmo
- Department of Anesthesia, McGill University
- Division of Pediatric Anesthesia
- Edwards Family Interdisciplinary Center for Complex Pain. Montreal Children's Hospital
- Research Institute, McGill University Health Center
- Alan Edwards for Research on Pain. McGill University, Montreal, Quebec, Canada
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Wang Y, Fu W, Gu Y, Fang W, Zhang Y, Jin C, Yin J, Wang W, Xu H, Ge X, Ye C, Tang L, Fang J, Wang D, Su L, Wang J, Zhang X, Feng R. Comparative survey among paediatricians, nurses and health information technicians on ethics implementation knowledge of and attitude towards social experiments based on medical artificial intelligence at children's hospitals in Shanghai: a cross-sectional study. BMJ Open 2023; 13:e071288. [PMID: 37989373 PMCID: PMC10668289 DOI: 10.1136/bmjopen-2022-071288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 11/05/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVES Implementing ethics is crucial to prevent harm and promote widespread benefits in social experiments based on medical artificial intelligence (MAI). However, insufficient information is available concerning this within the paediatric healthcare sector. We aimed to conduct a comparative survey among paediatricians, nurses and health information technicians regarding ethics implementation knowledge of and attitude towards MAI social experiments at children's hospitals in Shanghai. DESIGN AND SETTING A cross-sectional electronic questionnaire was administered from 1 July 2022 to 31 July 2022, at tertiary children's hospitals in Shanghai. PARTICIPANTS All the eligible individuals were recruited. The inclusion criteria were as follows: (1) should be a paediatrician, nurse and health information technician, (2) should have been engaged in or currently participating in social experiments based on MAI, and (3) voluntary participation in the survey. PRIMARY OUTCOME Ethics implementation knowledge of and attitude to MAI social experiments among paediatricians, nurses and health information technicians. RESULTS There were 137 paediatricians, 135 nurses and 60 health information technicians who responded to the questionnaire at tertiary children's hospitals. 2.4-9.6% of participants were familiar with ethics implementation knowledge of MAI social experiments. 31.9-86.1% of participants held an 'agree' ethics implementation attitude. Health information technicians accounted for the highest proportion of the participants who were familiar with the knowledge of implementing ethics, and paediatricians or nurses accounted for the highest proportion among those who held 'agree' attitudes. CONCLUSIONS There is a significant knowledge gap and variations in attitudes among paediatricians, nurses and health information technicians, which underscore the urgent need for individualised education and training programmes to enhance MAI ethics implementation in paediatric healthcare.
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Affiliation(s)
- Yingwen Wang
- Nursing Department, Children's Hospital of Fudan University, Shanghai, China
| | - Weijia Fu
- Medical Information Center, Children's Hospital of Fudan University, Shanghai, China
| | - Ying Gu
- Nursing Department, Children's Hospital of Fudan University, Shanghai, China
| | - Weihan Fang
- Shanghai Pinghe Bilingual School, Shanghai, China
| | - Yuejie Zhang
- School of Computer Science, Fudan University, Shanghai, China
| | - Cheng Jin
- School of Computer Science, Fudan University, Shanghai, China
| | - Jie Yin
- School of Philosophy, Fudan University, Shanghai, China
| | - Weibing Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Hong Xu
- Nephrology Department, Children's Hospital of Fudan University, Shanghai, China
| | - Xiaoling Ge
- Statistical and Data Management Center, Children's Hospital of Fudan University, Shanghai, China
| | - Chengjie Ye
- Medical Information Center, Children's Hospital of Fudan University, Shanghai, China
| | - Liangfeng Tang
- Medical Information Center, Children's Hospital of Fudan University, Shanghai, China
| | - Jinwu Fang
- School of Public Health, Fudan University, Shanghai, China
| | - Daoyang Wang
- School of Computer Science, Fudan University, Shanghai, China
| | - Ling Su
- Children's Hospital of Fudan University, Shanghai, China
| | - Jiayu Wang
- Medical Information Center, Children's Hospital of Fudan University, Shanghai, China
| | - Xiaobo Zhang
- Respiratory Department, Children's Hospital of Fudan University, Shanghai, China
| | - Rui Feng
- Medical Information Center, Children's Hospital of Fudan University, Shanghai, China
- School of Computer Science, Fudan University, Shanghai, China
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Antel R, Sahlas E, Gore G, Ingelmo P. Use of artificial intelligence in paediatric anaesthesia: a systematic review. BJA OPEN 2023; 5:100125. [PMID: 37587993 PMCID: PMC10430814 DOI: 10.1016/j.bjao.2023.100125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 01/03/2023] [Indexed: 08/18/2023]
Abstract
Objectives Although the development of artificial intelligence (AI) technologies in medicine has been significant, their application to paediatric anaesthesia is not well characterised. As the paediatric operating room is a data-rich environment that requires critical clinical decision-making, this systematic review aims to characterise the current use of AI in paediatric anaesthesia and to identify barriers to the successful integration of such technologies. Methods This review was registered with PROSPERO (CRD42022304610), the international registry for systematic reviews. The search strategy was prepared by a librarian and run in five electronic databases (Embase, Medline, Central, Scopus, and Web of Science). Collected articles were screened by two reviewers. Included studies described the use of AI for paediatric anaesthesia (<18 yr old) within the perioperative setting. Results From 3313 records identified in the initial search, 40 were included in this review. Identified applications of AI were described for patient risk factor prediction (24 studies; 60%), anaesthetic depth estimation (2; 5%), anaesthetic medication/technique decision guidance (2; 5%), intubation assistance (1; 2.5%), airway device selection (3; 7.5%), physiological variable monitoring (6; 15%), and operating room scheduling (2; 5%). Multiple domains of AI were discussed including machine learning, computer vision, fuzzy logic, and natural language processing. Conclusion There is an emerging literature regarding applications of AI for paediatric anaesthesia, and their clinical integration holds potential for ultimately improving patient outcomes. However, multiple barriers to their clinical integration remain including a lack of high-quality input data, lack of external validation/evaluation, and unclear generalisability to diverse settings. Systematic review protocol CRD42022304610 (PROSPERO).
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Affiliation(s)
- Ryan Antel
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Ella Sahlas
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Genevieve Gore
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada
| | - Pablo Ingelmo
- Department of Anesthesia, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada
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Saheb T, Saheb T, Carpenter DO. Mapping research strands of ethics of artificial intelligence in healthcare: A bibliometric and content analysis. Comput Biol Med 2021; 135:104660. [PMID: 34346319 DOI: 10.1016/j.compbiomed.2021.104660] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/15/2021] [Accepted: 07/15/2021] [Indexed: 02/07/2023]
Abstract
The growth of artificial intelligence in promoting healthcare is rapidly progressing. Notwithstanding its promising nature, however, AI in healthcare embodies certain ethical challenges as well. This research aims to delineate the most influential elements of scientific research on AI ethics in healthcare by conducting bibliometric, social network analysis, and cluster-based content analysis of scientific articles. Not only did the bibliometric analysis identify the most influential authors, countries, institutions, sources, and documents, but it also recognized four ethical concerns associated with 12 medical issues. These ethical categories are composed of normative, meta-ethics, epistemological and medical practice. The content analysis complemented this list of ethical categories and distinguished seven more ethical categories: ethics of relationships, medico-legal concerns, ethics of robots, ethics of ambient intelligence, patients' rights, physicians' rights, and ethics of predictive analytics. This analysis likewise identified 40 general research gaps in the literature and plausible future research strands. This analysis furthers conversations on the ethics of AI and associated emerging technologies such as nanotech and biotech in healthcare, hence, advances convergence research on the ethics of AI in healthcare. Practically, this research will provide a map for policymakers and AI engineers and scientists on what dimensions of AI-based medical interventions require stricter policies and guidelines and robust ethical design and development.
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Affiliation(s)
- Tahereh Saheb
- Management Studies Center, Tarbiat Modares University, Tehran, Iran.
| | - Tayebeh Saheb
- Assistant professor, Faculty of Law, Tarbiat Modares University, Tehran, Iran.
| | - David O Carpenter
- Director for the Institute for Health and the Environment, School of Public Health, State University of New York, University at Albany, USA.
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Lo C, Yu J, Görges M, Matava C. Anesthesia in the modern world of apps and technology: Implications and impact on wellness. Paediatr Anaesth 2021; 31:31-38. [PMID: 33119935 DOI: 10.1111/pan.14051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 02/01/2023]
Abstract
Recent decades have seen an unprecedented leap in digital innovation, with far-reaching implications in healthcare. Anesthesiologists have historically championed the adoption of new technologies. However, the rapid evolution of these technologies has outpaced attempts at studying their potential impact on healthcare providers' well-being. This document introduces several categories of workplace technologies commonly encountered by the anesthesiologist. We examine examples of novel technology and the impact of these digital interventions on the anesthesiologist's well-being. We also review popular personalized technology aimed at improving wellness and the impact on well-being examined. Finally, technology acceptance models are introduced to improve technology adoption, which, when appropriately applied, may minimize the negative impacts of technology on anesthesiologists' well-being. Incorporating quantitative, serial assessments of well-being as part of technology implementation are proposed as a future direction for examining the wellness impact of technology on anesthesiologists.
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Affiliation(s)
- Calvin Lo
- Department of Anesthesiology and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Julie Yu
- Department of Anesthesiology and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Matthias Görges
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Clyde Matava
- Department of Anesthesiology and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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A pharmacometrician's role in enhancing medication use in pregnancy and lactation. J Pharmacokinet Pharmacodyn 2020; 47:267-269. [PMID: 32803462 PMCID: PMC7473842 DOI: 10.1007/s10928-020-09707-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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