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Skuban-Eiseler T, Orzechowski M, Denkinger M, Kocar TD, Leinert C, Steger F. Artificial Intelligence-Based Clinical Decision Support Systems in Geriatrics: An Ethical Analysis. J Am Med Dir Assoc 2023; 24:1271-1276.e4. [PMID: 37453451 DOI: 10.1016/j.jamda.2023.06.008] [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: 04/15/2023] [Revised: 06/08/2023] [Accepted: 06/08/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES To provide an ethical analysis of the implications of the usage of artificial intelligence-supported clinical decision support systems (AI-CDSS) in geriatrics. DESIGN Ethical analysis based on the normative arguments regarding the use of AI-CDSS in geriatrics using a principle-based ethical framework. SETTING AND PARTICIPANTS Normative arguments identified in 29 articles on AI-CDSS in geriatrics. METHODS Our analysis is based on a literature search that was done to determine ethical arguments that are currently discussed regarding AI-CDSS. The relevant articles were subjected to a detailed qualitative analysis regarding the ethical considerations Supplementary Datamentioned therein. We then discussed the identified arguments within the frame of the 4 principles of medical ethics according to Beauchamp and Childress and with respect to the needs of frail older adults. RESULTS We found a total of 5089 articles; 29 articles met the inclusion criteria and were subsequently subjected to a detailed qualitative analysis. We could not identify any systematic analysis of the ethical implications of AI-CDSS in geriatrics. The ethical considerations are very unsystematic and scattered, and the existing literature has a predominantly technical focus emphasizing the technology's utility. In an extensive ethical analysis, we systematically discuss the ethical implications of the usage of AI-CDSS in geriatrics. CONCLUSIONS AND IMPLICATIONS AI-CDSS in geriatrics can be a great asset, especially when dealing with patients with cognitive disorders; however, from an ethical perspective, we see the need for further research. By using AI-CDSS, older patients' values and beliefs might be overlooked, and the quality of the doctor-patient relationship might be altered, endangering compliance to the 4 ethical principles of Beauchamp and Childress.
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Affiliation(s)
- Tobias Skuban-Eiseler
- Institute of the History, Philosophy and Ethics of Medicine, Faculty of Medicine, Ulm University, Ulm, Germany; kbo-Isar-Amper-Klinikum Region München, München-Haar, Germany.
| | - Marcin Orzechowski
- Institute of the History, Philosophy and Ethics of Medicine, Faculty of Medicine, Ulm University, Ulm, Germany
| | - Michael Denkinger
- Institute of Geriatric Research, Ulm University Medical Center, Ulm, Germany; AGAPLESION Bethesda Clinic Ulm, Ulm, Germany
| | - Thomas Derya Kocar
- Institute of Geriatric Research, Ulm University Medical Center, Ulm, Germany; AGAPLESION Bethesda Clinic Ulm, Ulm, Germany
| | - Christoph Leinert
- Institute of Geriatric Research, Ulm University Medical Center, Ulm, Germany; AGAPLESION Bethesda Clinic Ulm, Ulm, Germany
| | - Florian Steger
- Institute of the History, Philosophy and Ethics of Medicine, Faculty of Medicine, Ulm University, Ulm, Germany
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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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Zhang L, Li H, Wang T, Wang R, Cheng L, Wang G. Real-World Study: A Powerful Tool for Malignant Tumor Research in General Surgery. Cancers (Basel) 2022; 14:5408. [PMID: 36358825 PMCID: PMC9656785 DOI: 10.3390/cancers14215408] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/21/2022] [Accepted: 10/31/2022] [Indexed: 03/01/2024] Open
Abstract
Real-world study (RWS) is a method to draw conclusions by collecting and analyzing real-world data under a real clinical background. Compared with traditional randomized controlled trials (RCTs), RWSs are favored by clinicians because of their low cost and good extrapolation. In recent years, RWS has made remarkable achievements in the field of general surgery, especially in the drug treatment of advanced malignant tumors. Therefore, to further understand the main contents of the existing RWS and the application prospect of RWS in the future, this paper systematically reviews the clinical application of RWS in malignant tumors in general surgery in the past three years.
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Affiliation(s)
- Liang Zhang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
| | - He Li
- Department of Centric Operating Room, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
| | - TianFu Wang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
| | - RuiXin Wang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
| | - Long Cheng
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
| | - Gang Wang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
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Ogata S, Fujita F, Fujiyoshi K, Sudou T, Yoshida T, Koushi K, Murotani K, Yamauchi S, Sugihara K, Akagi Y. Prognostic Value of Preoperative Carcinoembryonic Antigen and Carbohydrate Antigen 19-9 Levels for Adjuvant Chemotherapy in Stage II Colorectal Cancer: A Nationwide Multicenter Retrospective Study. J Anus Rectum Colon 2022; 6:249-258. [PMID: 36348948 PMCID: PMC9613416 DOI: 10.23922/jarc.2022-020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/25/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Adjuvant chemotherapy for stage II colorectal cancer patients with high-risk factors for recurrence can be useful; however, its advantage in prognosis remains to be controversial. Thus, in this study, we aimed to assess whether a combination of preoperative serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels can predict the prognosis and advantage of adjuvant chemotherapy. METHODS Using a Japanese nationwide database, in total, 3,688 patients with curative resected stage II colorectal cancer were registered retrospectively between 2008 and 2012 in 24 referral institutions. Patients were classified into three groups as follows: Group A (both non-high levels of CEA and CA19-9), Group B (either high levels of CEA or CA19-9), and Group C (both high levels of CEA and CA19-9). RESULTS Multivariable Cox regression analysis, adjusting the depth of tumor invasion, number of dissected lymph nodes, tumor differentiation, lymphatic and venous invasion, and other covariates, showed that the 5-year disease-free survival and overall survival were shorter in Group C than in Groups A and B. Furthermore, in Group C, the 5-year disease-free survival rate was improved in the surgery-plus-AC group compared to the surgery-alone group. CONCLUSIONS As with existing high-risk factors for recurrence, the combination assessment of preoperative serum CEA and CA19-9 can predict the prognosis for colorectal cancer. Adjuvant chemotherapy may provide a prolonged disease-free survival advantage in stage II colorectal cancer patients with high levels of both tumor markers.
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Affiliation(s)
- Suguru Ogata
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Kenji Fujiyoshi
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Tomoya Sudou
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Takefumi Yoshida
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Kenichi Koushi
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | | | - Shinichi Yamauchi
- Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenichi Sugihara
- Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
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Huang J, Zhang Y, Zhou J, Fang M, Wu X, Luo Y, Huang Q, Ouyang Y, Xiao S. Development and validation of a prognostic nomogram for patients with stage II colon mucinous adenocarcinoma. Int J Colorectal Dis 2022; 37:2173-2184. [PMID: 36149446 DOI: 10.1007/s00384-022-04251-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE Mucinous histology is generally considered as a risk factor of prognosis in stage II colon cancer, but there is no appropriate model for prognostic evaluation and treatment decision in patients with stage II colon mucinous adenocarcinoma (C-MAC) Thus, it is urgent to develop a comprehensive, individualized evaluation tool to reflect the heterogeneity of stage II C-MAC. METHODS Patients with stage II C-MAC who underwent surgical treatment in the Surveillance, Epidemiology, and End Results Program were enrolled and randomly divided into training cohort (70%) and internal validation cohort (30%). Prognostic predictors which were determined by univariate and multivariate analysis in the training cohort were included in the nomogram. The calibration curves, decision curve analysis, X-tile analysis, and Kaplan-Meier curve of the nomogram were validated in the internal validation cohort. RESULTS Three thousand seven hundred sixty-two patients of stage II C-MAC were enrolled. The age, pathological T (pT) stage, tumor number, serum carcinoembryonic antigen (CEA), and perineural invasion (PNI) were independent predictors of overall survival (OS), which were used to establish a nomogram. Calibration curves of the nomogram indicated good consistency between nomogram prediction and actual survival for 1-, 3- and 5-year OS. Besides, patients with stage II C-MAC could be divided into high-, middle-, and low-risk subgroups by the nomogram. Further subgroup analysis indicated that patients in the high-risk group could have a survival benefit from chemotherapy after surgical treatment. CONCLUSIONS We established the first nomogram to accurately predict the survival of stage II C-MAC patients who underwent surgical treatment. In addition, the nomogram identified low-, middle-, and high-risk subgroups of patients and found chemotherapy might improve survival in the high-risk subgroup of stage II C-MAC patients.
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Affiliation(s)
- Jia Huang
- The First Affiliated Hospital, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China.,The First Affiliated Hospital, Department of Ultrasound Medicine, Hengyang Medical School, University of South China Hengyang, Hunan, People's Republic of China
| | - Yiwei Zhang
- The First Affiliated Hospital, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
| | - Jia Zhou
- The First Affiliated Hospital, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China.,The First Affiliated Hospital, Department of Ultrasound Medicine, Hengyang Medical School, University of South China Hengyang, Hunan, People's Republic of China
| | - Min Fang
- The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Xiaofeng Wu
- The First Affiliated Hospital, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China.,The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Yuhang Luo
- The First Affiliated Hospital, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
| | - Qiulin Huang
- The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China.
| | - Yujuan Ouyang
- Nuclear Industrial Hygiene School, University of South China, Hengyang, Hunan, 421001, People's Republic of China.
| | - Shuai Xiao
- The First Affiliated Hospital, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China. .,The First Affiliated Hospital, Department of Gastrointestinal Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China.
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Giani A, Bertoglio CL, Mazzola M, Giusti I, Achilli P, Carnevali P, Origi M, Magistro C, Ferrari G. Mid-term oncological outcomes after complete versus conventional mesocolic excision for right-sided colon cancer: a propensity score matching analysis. Surg Endosc 2022; 36:6489-6496. [PMID: 35028735 DOI: 10.1007/s00464-021-09001-z] [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: 09/28/2021] [Accepted: 12/31/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The correct extent of mesocolic dissection for right-sided colon cancer (RCC) is still under debate. Complete mesocolic excision (CME) has not gained wide diffusion, mainly due to its technical complexity and unclear oncological superiority. This study aims to evaluate oncological outcomes of CME compared with non-complete mesocolic excision (NCME) during resection for I-III stage RCC. METHOD Prospectively collected data of patients who underwent surgery between 2010 and 2018 were retrospectively analysed. 1:1 Propensity score matching (PSM) was used to balance baseline characteristics of CME and NCME patients. The primary endpoint of the study was local recurrence-free survival (LRFS). The two groups were also compared in terms of short-term outcomes, distant recurrence-free survival, disease-free survival, and overall survival. RESULTS Of the 444 patients included in the study, 292 were correctly matched after PSM, 146 in each group. The median follow-up was 45 months (IQR 33-63). Conversion rate, complications, and 90-day mortality were comparable in both groups. The median number of lymph nodes harvested was higher in CME patients (23 vs 19, p = 0.034). 3-year LRFS rates for CME patients was 100% and 95.6% for NCME (log-rank p = 0.028). At 3 years, there were no differences between the groups in terms of overall survival, distant recurrence-free survival, and disease-free survival. CONCLUSION Our PSM cohort study shows that CME is safe, provides a higher number of lymph nodes harvested, and is associated with better local recurrence-free survival.
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Affiliation(s)
- Alessandro Giani
- Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore, 3, 20162, Milan, Italy.
| | - Camillo Leonardo Bertoglio
- Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore, 3, 20162, Milan, Italy
| | - Michele Mazzola
- Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore, 3, 20162, Milan, Italy
| | - Irene Giusti
- Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore, 3, 20162, Milan, Italy
| | - Pietro Achilli
- Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore, 3, 20162, Milan, Italy
| | - Pietro Carnevali
- Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore, 3, 20162, Milan, Italy
| | - Matteo Origi
- Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore, 3, 20162, Milan, Italy
| | - Carmelo Magistro
- Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore, 3, 20162, Milan, Italy
| | - Giovanni Ferrari
- Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore, 3, 20162, Milan, Italy
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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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