With the worldwide analysis,heart disease is considered a significant threat and extensively increases the mortality rate.Thus,the investigators mitigate to predict the occurrence of heart disease in an earlier stage ...With the worldwide analysis,heart disease is considered a significant threat and extensively increases the mortality rate.Thus,the investigators mitigate to predict the occurrence of heart disease in an earlier stage using the design of a better Clinical Decision Support System(CDSS).Generally,CDSS is used to predict the individuals’heart disease and periodically update the condition of the patients.This research proposes a novel heart disease prediction system with CDSS composed of a clustering model for noise removal to predict and eliminate outliers.Here,the Synthetic Over-sampling prediction model is integrated with the cluster concept to balance the training data and the Adaboost classifier model is used to predict heart disease.Then,the optimization is achieved using the Adam Optimizer(AO)model with the publicly available dataset known as the Stalog dataset.This flowis used to construct the model,and the evaluation is done with various prevailing approaches like Decision tree,Random Forest,Logistic Regression,Naive Bayes and so on.The statistical analysis is done with theWilcoxon rank-summethod for extracting the p-value of the model.The observed results show that the proposed model outperforms the various existing approaches and attains efficient prediction accuracy.This model helps physicians make better decisions during complex conditions and diagnose the disease at an earlier stage.Thus,the earlier treatment process helps to eliminate the death rate.Here,simulation is done withMATLAB 2016b,and metrics like accuracy,precision-recall,F-measure,p-value,ROC are analyzed to show the significance of the model.展开更多
Objective:Artificial intelligence(AI)has a big impact on healthcare now and in the future.Nurses play an important role in the medical field and will benefit greatly from this technology.AI-Enabled Clinical Decision S...Objective:Artificial intelligence(AI)has a big impact on healthcare now and in the future.Nurses play an important role in the medical field and will benefit greatly from this technology.AI-Enabled Clinical Decision Support Systems have received a great deal of attention recently.Bibliometric analysis can offer an objective,systematic,and comprehensive analysis of a specific field with a vast background.However,no bibliometric analysis has investigated AI-enabled clinical decision support systems research in nursing.The purpose of research to determine the characteristics of articles about the global performance and development of AI-enabled clinical decision support systems research in nursing.Methods:In this study,the bibliometric approach was used to estimate the searched data on clinical decision support systems research in nursing from 2009 to 2022,and we also utilized CiteSpace and VOSviewer software to build visualizing maps to assess the contribution of different journals,authors,et al.,as well as to identify research hot spots and promising future trends in this research field.Result:From 2009 to 2022,a total of 2,159 publications were retrieved.The number of publications and citations on AI-enabled clinical decision support systems research in nursing has increased obvious ly in recent years.However,they are understudied in the field of nursing and there is a compelling need to develop more high-quality research.Conclusion:AI-Enabled Nursing Decision Support System use in clinical practice is still in its early stages.These analyses and results hope to provide useful information and references for future research directions for researchers and nursing practitioners who use AI-enabled clinical decision support systems.展开更多
Chronic obstructive pulmonary disease(COPD)is a serious chronic respiratory disease.Improving the ability to identify patients with COPD in primary medical institutions is important to prevent and treat the disease.Wi...Chronic obstructive pulmonary disease(COPD)is a serious chronic respiratory disease.Improving the ability to identify patients with COPD in primary medical institutions is important to prevent and treat the disease.With the continuous development of medical digitization,the application of big data informatization in the medical and health fields has become possible.Recently,applying innovative technologies such as big data analysis,machine learning,and artificial intelligence-assisted decision-making in the medical field has become an interdisciplinary research hotspot.Based on the identification and diagnosis of COPD in the high-risk population,this study proposes a convenient and effective clinical decision support system to help identify patients with COPD in primary health institutions.The results of the preliminary experiments show that the proposed method is convenient and effective compared with the existing methods.展开更多
This study aimed to develop a clinical Decision Support Model (DSM) which is software that provides physicians and other healthcare stakeholders with patient-specific assessments and recommendation in aiding clinical ...This study aimed to develop a clinical Decision Support Model (DSM) which is software that provides physicians and other healthcare stakeholders with patient-specific assessments and recommendation in aiding clinical decision-making while discharging Breast cancer patient since the diagnostics and discharge problem is often overwhelming for a clinician to process at the point of care or in urgent situations. The model incorporates Breast cancer patient-specific data that are well-structured having been attained from a prestudy’s administered questionnaires and current evidence-based guidelines. Obtained dataset of the prestudy’s questionnaires is processed via data mining techniques to generate an optimal clinical decision tree classifier model which serves physicians in enhancing their decision-making process while discharging a breast cancer patient on basic cognitive processes involved in medical thinking hence new, better-formed, and superior outcomes. The model also improves the quality of assessments by constructing predictive discharging models from code attributes enabling timely detection of deterioration in the quality of health of a breast cancer patient upon discharge. The outcome of implementing this study is a decision support model that bridges the gap occasioned by less informed clinical Breast cancer discharge that is based merely on experts’ opinions which is insufficiently reinforced for better treatment outcomes. The reinforced discharge decision for better treatment outcomes is through timely deployment of the decision support model to work hand in hand with the expertise in deriving an integrative discharge decision and has been an agreed strategy to eliminate the foreseeable deteriorating quality of health for a discharged breast cancer patients and surging rates of mortality blamed on mistrusted discharge decisions. In this paper, we will discuss breast cancer clinical knowledge, data mining techniques, the classifying model accuracy, and the Python web-based decision support model that predicts avoidable re-hospitalization of a breast cancer patient through an informed clinical discharging support model.展开更多
This study offers a framework for a breast cancer computer-aided treat-ment prediction(CATP)system.The rising death rate among women due to breast cancer is a worldwide health concern that can only be addressed by ear...This study offers a framework for a breast cancer computer-aided treat-ment prediction(CATP)system.The rising death rate among women due to breast cancer is a worldwide health concern that can only be addressed by early diagno-sis and frequent screening.Mammography has been the most utilized breast ima-ging technique to date.Radiologists have begun to use computer-aided detection and diagnosis(CAD)systems to improve the accuracy of breast cancer diagnosis by minimizing human errors.Despite the progress of artificial intelligence(AI)in the medical field,this study indicates that systems that can anticipate a treatment plan once a patient has been diagnosed with cancer are few and not widely used.Having such a system will assist clinicians in determining the optimal treatment plan and avoid exposing a patient to unnecessary hazardous treatment that wastes a significant amount of money.To develop the prediction model,data from 336,525 patients from the SEER dataset were split into training(80%),and testing(20%)sets.Decision Trees,Random Forest,XGBoost,and CatBoost are utilized with feature importance to build the treatment prediction model.The best overall Area Under the Curve(AUC)achieved was 0.91 using Random Forest on the SEER dataset.展开更多
BACKGROUND Non-invasive tests,such as Fibrosis-4 index and transient elastography(com-monly FibroScan),are utilized in clinical pathways to risk stratify and diagnose non-alcoholic fatty liver disease(NAFLD).In 2018,a...BACKGROUND Non-invasive tests,such as Fibrosis-4 index and transient elastography(com-monly FibroScan),are utilized in clinical pathways to risk stratify and diagnose non-alcoholic fatty liver disease(NAFLD).In 2018,a clinical decision support tool(CDST)was implemented to guide primary care providers(PCPs)on use of FibroScan for NAFLD.AIM To analyze how this CDST impacted health care utilization and patient outcomes.METHODS We performed a retrospective review of adults who had FibroScan for NAFLD indication from January 2015 to December 2017(pre-CDST)or January 2018 to December 2020(post-CDST).Outcomes included FibroScan result,laboratory tests,imaging studies,specialty referral,patient morbidity and mortality.RESULTS We identified 958 patients who had FibroScan,115 before and 843 after the CDST was implemented.The percentage of FibroScans ordered by PCPs increased from 33%to 67.1%.The percentage of patients diagnosed with early F1 fibrosis,on a scale from F0 to F4,increased from 7.8%to 14.2%.Those diagnosed with ad-vanced F4 fibrosis decreased from 28.7%to 16.5%.There were fewer laboratory tests,imaging studies and biopsy after the CDST was implemented.Though there were more specialty referrals placed after the CDST was implemented,multivariate analysis revealed that healthcare utilization aligned with fibrosis score,whereby patients with more advanced disease had more referrals.Very few patients were hospitalized or died.CONCLUSION This CDST empowered PCPs to diagnose and manage patients with NAFLD with appropriate allocation of care towards patients with more advanced disease.展开更多
In the era of advanced machine learning techniques,the development of accurate predictive models for complex medical conditions,such as thyroid cancer,has shown remarkable progress.Accurate predictivemodels for thyroi...In the era of advanced machine learning techniques,the development of accurate predictive models for complex medical conditions,such as thyroid cancer,has shown remarkable progress.Accurate predictivemodels for thyroid cancer enhance early detection,improve resource allocation,and reduce overtreatment.However,the widespread adoption of these models in clinical practice demands predictive performance along with interpretability and transparency.This paper proposes a novel association-rule based feature-integratedmachine learning model which shows better classification and prediction accuracy than present state-of-the-artmodels.Our study also focuses on the application of SHapley Additive exPlanations(SHAP)values as a powerful tool for explaining thyroid cancer prediction models.In the proposed method,the association-rule based feature integration framework identifies frequently occurring attribute combinations in the dataset.The original dataset is used in trainingmachine learning models,and further used in generating SHAP values fromthesemodels.In the next phase,the dataset is integrated with the dominant feature sets identified through association-rule based analysis.This new integrated dataset is used in re-training the machine learning models.The new SHAP values generated from these models help in validating the contributions of feature sets in predicting malignancy.The conventional machine learning models lack interpretability,which can hinder their integration into clinical decision-making systems.In this study,the SHAP values are introduced along with association-rule based feature integration as a comprehensive framework for understanding the contributions of feature sets inmodelling the predictions.The study discusses the importance of reliable predictive models for early diagnosis of thyroid cancer,and a validation framework of explainability.The proposed model shows an accuracy of 93.48%.Performance metrics such as precision,recall,F1-score,and the area under the receiver operating characteristic(AUROC)are also higher than the baseline models.The results of the proposed model help us identify the dominant feature sets that impact thyroid cancer classification and prediction.The features{calcification}and{shape}consistently emerged as the top-ranked features associated with thyroid malignancy,in both association-rule based interestingnessmetric values and SHAPmethods.The paper highlights the potential of the rule-based integrated models with SHAP in bridging the gap between the machine learning predictions and the interpretability of this prediction which is required for real-world medical applications.展开更多
AIM To determine clinical scores important for automated calculation in the inpatient setting.METHODS A modified Delphi methodology was used to create consensus of important clinical scores for inpatient practice. A l...AIM To determine clinical scores important for automated calculation in the inpatient setting.METHODS A modified Delphi methodology was used to create consensus of important clinical scores for inpatient practice. A list of 176 externally validated clinical scores were identified from freely available internet-based services frequently used by clinicians. Scores were categorized based on pertinent specialty and a customized survey was created for each clinician specialty group. Clinicians were asked to rank each score based on importance of automated calculation to their clinical practice in three categories-"not important", "nice to have", or "very important". Surveys were solicited via specialty-group listserv over a 3-mo interval. Respondents must have been practicing physicians with more than 20% clinical time spent in the inpatient setting. Within each specialty, consensus was established for any clinical score with greater than 70% of responses in a single category and a minimum of 10 responses. Logistic regression was performed to determine predictors of automation importance.RESULTS Seventy-nine divided by one hundred and forty-four(54.9%) surveys were completed and 72/144(50%) surveys were completed by eligible respondents. Only the critical care and internal medicine specialties surpassed the 10-respondent threshold(14 respondents each). For internists, 2/110(1.8%) of scores were "very important" and 73/110(66.4%) were "nice to have". For intensivists, no scores were "very important" and 26/76(34.2%) were "nice to have". Only the number of medical history(OR = 2.34; 95%CI: 1.26-4.67; P < 0.05) and vital sign(OR = 1.88; 95%CI: 1.03-3.68; P < 0.05) variables for clinical scores used by internists was predictive of desire for automation. CONCLUSION Few clinical scores were deemed "very important" for automated calculation. Future efforts towards score calculator automation should focus on technically feasible "nice to have" scores.展开更多
The purpose of this paper is to discuss the development of medical informatization in the era of big data.Through literature review and theoretical analysis,the development of medical informatization in the era of big...The purpose of this paper is to discuss the development of medical informatization in the era of big data.Through literature review and theoretical analysis,the development of medical informatization in the era of big data is deeply discussed.The results show that medical informatization has developed rapidly in the era of big data,and its role in clinical decision-making,scientific research,teaching,and management has become increasingly prominent.The development of medical informatization in the era of big data has important purposes and methods,which can produce important results and conclusions and provide strong support for the development of the medical field.展开更多
Artificial Intelligence(AI)is finding increasing application in healthcare monitoring.Machine learning systems are utilized for monitoring patient health through the use of IoT sensor,which keep track of the physiolog...Artificial Intelligence(AI)is finding increasing application in healthcare monitoring.Machine learning systems are utilized for monitoring patient health through the use of IoT sensor,which keep track of the physiological state by way of various health data.Thus,early detection of any disease or derangement can aid doctors in saving patients’lives.However,there are some challenges associated with predicting health status using the common algorithms,such as time requirements,chances of errors,and improper classification.We propose an Artificial Krill Herd based on the Random Forest(AKHRF)technique for monitoring patients’health and eliciting an optimal prescription based on their health status.To begin with,various patient datasets were collected and trained into the system using IoT sensors.As a result,the framework developed includes four processes:preprocessing,feature extraction,classification,and result visibility.Additionally,preprocessing removes errors,noise,and missing values from the dataset,whereas feature extraction extracts the relevant information.Then,in the classification layer,we updated the fitness function of the krill herd to classify the patient’s health status and also generate a prescription.We found that the results fromthe proposed framework are comparable to the results from other state-of-the-art techniques in terms of sensitivity,specificity,Area under the Curve(AUC),accuracy,precision,recall,and F-measure.展开更多
Research into medical artificial intelligence(AI)has made significant advances in recent years,including surgical applications.This scoping review investigated AI-based decision support systems targeted at the intraop...Research into medical artificial intelligence(AI)has made significant advances in recent years,including surgical applications.This scoping review investigated AI-based decision support systems targeted at the intraoperative phase of surgery and found a wide range of technological approaches applied across several surgical specialties.Within the twenty-one(n=21)included papers,three main categories of motivations were identified for developing such technologies:(1)augmenting the information available to surgeons,(2)accelerating intraoperative pathology,and(3)recommending surgical steps.While many of the proposals hold promise for improving patient outcomes,important methodological shortcomings were observed in most of the reviewed papers that made it difficult to assess the clinical significance of the reported performance statistics.Despite limitations,the current state of this field suggests that a number of opportunities exist for future researchers and clinicians to work on AI for surgical decision support with exciting implications for improving surgical care.展开更多
New technologies such as artificial intelligence,the internet of things,big data,and cloud computing have changed the overall society and economy,and the medical field particularly has tried to combine traditional exa...New technologies such as artificial intelligence,the internet of things,big data,and cloud computing have changed the overall society and economy,and the medical field particularly has tried to combine traditional examination methods and new technologies.The most remarkable field in medical research is the technology of predicting high dementia risk group using big data and artificial intelligence.This review introduces:(1)the definition,main concepts,and classification of machine learning and overall distinction of it from traditional statistical analysis models;and(2)the latest studies in mental science to detect dementia and predict high-risk groups in order to help competent researchers who are challenging medical artificial intelligence in the field of psychiatry.As a result of reviewing 4 studies that used machine learning to discriminate high-risk groups of dementia,various machine learning algorithms such as boosting model,artificial neural network,and random forest were used for predicting dementia.The development of machine learning algorithms will change primary care by applying advanced machine learning algorithms to detect high dementia risk groups in the future.展开更多
Treatment plan selection is a complex process because it sometimes needs sufficient experience and clinical information.Nowadays it is even harder for doctors to select an appropriate treatment plan for certain patien...Treatment plan selection is a complex process because it sometimes needs sufficient experience and clinical information.Nowadays it is even harder for doctors to select an appropriate treatment plan for certain patients since doctors might encounter difficulties in obtaining the right information and analyzing the diverse clinical data.In order to improve the effectiveness of clinical decision making in complicated information system environments,we first propose a linked data-based approach for treatment plan selection.The approach integrates the patients’clinical records in hospitals with open linked data sources out of hospitals.Then,based on the linked data net,treatment plan selection is carried on aided by similar historical therapy cases.Finally,we reorganize the electronic medical records of 97 colon cancer patients using the linked data model and count the similarity of these records to help treatment selecting.The experiment shows the usability of our method in supporting clinical decisions.展开更多
Globally,there is a great gulf between medical knowledge and clinical practice.Translating knowledge into clinical decision support(CDS) application has become the biggest challenge faced by evidence based medicine.Th...Globally,there is a great gulf between medical knowledge and clinical practice.Translating knowledge into clinical decision support(CDS) application has become the biggest challenge faced by evidence based medicine.This paper proposed a comprehensive motivation framework to facilitate knowledge translation in healthcare.Based on a unified medical knowledge ontology and knowledge base,the framework provides an infrastructure of fundamental services,such as inference service and data acquisition,to support development of knowledge-driven CDS applications and integration into clinical workflow.The framework has been implemented in a 2600-bed Chinese hospital,and is able to reduce the time and cost of developing typical CDS applications.展开更多
The wide use and abuse of antibiotics could make antimicrobial resistance(AMR)an increasingly serious issue that threatens global health and imposes an enormous burden on society and the economy.To avoid the crisis of...The wide use and abuse of antibiotics could make antimicrobial resistance(AMR)an increasingly serious issue that threatens global health and imposes an enormous burden on society and the economy.To avoid the crisis of AMR,we have to fundamentally change our approach.Artificial intelligence(AI)represents a new paradigm to combat AMR.Thus,various AI approaches to this problem have sprung up,some of which may be considered successful cases of domain-specific AI applications in AMR.However,to the best of our knowledge,there is no systematic review illustrating the use of these AI-based applications for AMR.Therefore,this review briefly introduces how to employ AI technology against AMR by using the predictive AMR model,the rational use of antibiotics,antimicrobial peptides(AMPs)and antibiotic combinations,as well as future research directions.展开更多
On May 25,2019,the World Health Assembly approved the eleventh revision of the International Statistical Classification of Diseases and Related Health Problems(ICD-11),containing a chapter on traditional medicine.This...On May 25,2019,the World Health Assembly approved the eleventh revision of the International Statistical Classification of Diseases and Related Health Problems(ICD-11),containing a chapter on traditional medicine.This means that the traditional East Asian medicine(TEAM)is now officially recognized as a part of mainstream medical practice.However,the patterns presented in the ICD-11 traditional medicine chapter are only the tip of the iceberg of TEAM clinical practice,and it will be necessary to supplement and upgrade the contents.In order to implement this,objectification and standardization of TEAM must be premised,and grafting with proper modern science and technology is imperative.Pattern Identification and Prescription Expert-11(PIPE-11),which is a TEAM clinical decision support system,adopts vastly from clinical literature on pattern identification and the prescription.By adopting the rule-based reasoning method,the way of diagnosis and prescription by a TEAM practitioner in actual clinical practice is implemented as it is.PIPE-11 could support to improve both the accuracy of medical diagnosis and the reliability of the medical treatment of TEAM in clinical practices.In the field of research,it might facilitate the usage for reliable reference for symptoms and signs retrieval and patient simulation.In the field of education,it can provide a high level of training for learning pattern identification and prescription,and further be used to reinforce skills of diagnosis and prescription by providing self-simulation methods.Therefore,PIPE-11 as a digital application is expected to support the traditional medicine chapter of ICD-11 to successfully contribute to the improvement of human health.展开更多
Background:Accurate risk stratification of critically ill patients with coronavirus disease 2019(COVID-19)is essential for optimizing resource allocation,delivering targeted interventions,and maximizing patient surviv...Background:Accurate risk stratification of critically ill patients with coronavirus disease 2019(COVID-19)is essential for optimizing resource allocation,delivering targeted interventions,and maximizing patient survival probability.Machine learning(ML)techniques are attracting increased interest for the development of prediction models as they excel in the analysis of complex signals in data-rich environments such as critical care.Methods:We retrieved data on patients with COVID-19 admitted to an intensive care unit(ICU)between March and October 2020 from the RIsk Stratification in COVID-19 patients in the Intensive Care Unit(RISC-19-ICU)registry.We applied the Extreme Gradient Boosting(XGBoost)algorithm to the data to predict as a binary out-come the increase or decrease in patients’Sequential Organ Failure Assessment(SOFA)score on day 5 after ICU admission.The model was iteratively cross-validated in different subsets of the study cohort.Results:The final study population consisted of 675 patients.The XGBoost model correctly predicted a decrease in SOFA score in 320/385(83%)critically ill COVID-19 patients,and an increase in the score in 210/290(72%)patients.The area under the mean receiver operating characteristic curve for XGBoost was significantly higher than that for the logistic regression model(0.86 vs.0.69,P<0.01[paired t-test with 95%confidence interval]).Conclusions:The XGBoost model predicted the change in SOFA score in critically ill COVID-19 patients admitted to the ICU and can guide clinical decision support systems(CDSSs)aimed at optimizing available resources.展开更多
文摘With the worldwide analysis,heart disease is considered a significant threat and extensively increases the mortality rate.Thus,the investigators mitigate to predict the occurrence of heart disease in an earlier stage using the design of a better Clinical Decision Support System(CDSS).Generally,CDSS is used to predict the individuals’heart disease and periodically update the condition of the patients.This research proposes a novel heart disease prediction system with CDSS composed of a clustering model for noise removal to predict and eliminate outliers.Here,the Synthetic Over-sampling prediction model is integrated with the cluster concept to balance the training data and the Adaboost classifier model is used to predict heart disease.Then,the optimization is achieved using the Adam Optimizer(AO)model with the publicly available dataset known as the Stalog dataset.This flowis used to construct the model,and the evaluation is done with various prevailing approaches like Decision tree,Random Forest,Logistic Regression,Naive Bayes and so on.The statistical analysis is done with theWilcoxon rank-summethod for extracting the p-value of the model.The observed results show that the proposed model outperforms the various existing approaches and attains efficient prediction accuracy.This model helps physicians make better decisions during complex conditions and diagnose the disease at an earlier stage.Thus,the earlier treatment process helps to eliminate the death rate.Here,simulation is done withMATLAB 2016b,and metrics like accuracy,precision-recall,F-measure,p-value,ROC are analyzed to show the significance of the model.
基金Lan-Fang Qin was supported by National Innovation and Entrepreneurship Training Program for College Students(2022KYCX69)Rui Wang was supported by the Nursing Subject(Zhejiang Province"13th Five-Year Plan"Characteristic Specialty Construction Project)under Grant(JY30001)Chong-Bin Liu supported by the grants from National Natural Science Foundation of Zhejiang Province,No.LY21H260005 and No.2017290-40.
文摘Objective:Artificial intelligence(AI)has a big impact on healthcare now and in the future.Nurses play an important role in the medical field and will benefit greatly from this technology.AI-Enabled Clinical Decision Support Systems have received a great deal of attention recently.Bibliometric analysis can offer an objective,systematic,and comprehensive analysis of a specific field with a vast background.However,no bibliometric analysis has investigated AI-enabled clinical decision support systems research in nursing.The purpose of research to determine the characteristics of articles about the global performance and development of AI-enabled clinical decision support systems research in nursing.Methods:In this study,the bibliometric approach was used to estimate the searched data on clinical decision support systems research in nursing from 2009 to 2022,and we also utilized CiteSpace and VOSviewer software to build visualizing maps to assess the contribution of different journals,authors,et al.,as well as to identify research hot spots and promising future trends in this research field.Result:From 2009 to 2022,a total of 2,159 publications were retrieved.The number of publications and citations on AI-enabled clinical decision support systems research in nursing has increased obvious ly in recent years.However,they are understudied in the field of nursing and there is a compelling need to develop more high-quality research.Conclusion:AI-Enabled Nursing Decision Support System use in clinical practice is still in its early stages.These analyses and results hope to provide useful information and references for future research directions for researchers and nursing practitioners who use AI-enabled clinical decision support systems.
基金This work was supported by the Major Research Program of the National Natural Science Foundation of China(No.91843302).
文摘Chronic obstructive pulmonary disease(COPD)is a serious chronic respiratory disease.Improving the ability to identify patients with COPD in primary medical institutions is important to prevent and treat the disease.With the continuous development of medical digitization,the application of big data informatization in the medical and health fields has become possible.Recently,applying innovative technologies such as big data analysis,machine learning,and artificial intelligence-assisted decision-making in the medical field has become an interdisciplinary research hotspot.Based on the identification and diagnosis of COPD in the high-risk population,this study proposes a convenient and effective clinical decision support system to help identify patients with COPD in primary health institutions.The results of the preliminary experiments show that the proposed method is convenient and effective compared with the existing methods.
文摘This study aimed to develop a clinical Decision Support Model (DSM) which is software that provides physicians and other healthcare stakeholders with patient-specific assessments and recommendation in aiding clinical decision-making while discharging Breast cancer patient since the diagnostics and discharge problem is often overwhelming for a clinician to process at the point of care or in urgent situations. The model incorporates Breast cancer patient-specific data that are well-structured having been attained from a prestudy’s administered questionnaires and current evidence-based guidelines. Obtained dataset of the prestudy’s questionnaires is processed via data mining techniques to generate an optimal clinical decision tree classifier model which serves physicians in enhancing their decision-making process while discharging a breast cancer patient on basic cognitive processes involved in medical thinking hence new, better-formed, and superior outcomes. The model also improves the quality of assessments by constructing predictive discharging models from code attributes enabling timely detection of deterioration in the quality of health of a breast cancer patient upon discharge. The outcome of implementing this study is a decision support model that bridges the gap occasioned by less informed clinical Breast cancer discharge that is based merely on experts’ opinions which is insufficiently reinforced for better treatment outcomes. The reinforced discharge decision for better treatment outcomes is through timely deployment of the decision support model to work hand in hand with the expertise in deriving an integrative discharge decision and has been an agreed strategy to eliminate the foreseeable deteriorating quality of health for a discharged breast cancer patients and surging rates of mortality blamed on mistrusted discharge decisions. In this paper, we will discuss breast cancer clinical knowledge, data mining techniques, the classifying model accuracy, and the Python web-based decision support model that predicts avoidable re-hospitalization of a breast cancer patient through an informed clinical discharging support model.
基金N.I.R.R.and K.I.M.have received a grant from the Malaysian Ministry of Higher Education.Grant number:203/PKOMP/6712025,http://portal.mygrants.gov.my/main.php.
文摘This study offers a framework for a breast cancer computer-aided treat-ment prediction(CATP)system.The rising death rate among women due to breast cancer is a worldwide health concern that can only be addressed by early diagno-sis and frequent screening.Mammography has been the most utilized breast ima-ging technique to date.Radiologists have begun to use computer-aided detection and diagnosis(CAD)systems to improve the accuracy of breast cancer diagnosis by minimizing human errors.Despite the progress of artificial intelligence(AI)in the medical field,this study indicates that systems that can anticipate a treatment plan once a patient has been diagnosed with cancer are few and not widely used.Having such a system will assist clinicians in determining the optimal treatment plan and avoid exposing a patient to unnecessary hazardous treatment that wastes a significant amount of money.To develop the prediction model,data from 336,525 patients from the SEER dataset were split into training(80%),and testing(20%)sets.Decision Trees,Random Forest,XGBoost,and CatBoost are utilized with feature importance to build the treatment prediction model.The best overall Area Under the Curve(AUC)achieved was 0.91 using Random Forest on the SEER dataset.
文摘BACKGROUND Non-invasive tests,such as Fibrosis-4 index and transient elastography(com-monly FibroScan),are utilized in clinical pathways to risk stratify and diagnose non-alcoholic fatty liver disease(NAFLD).In 2018,a clinical decision support tool(CDST)was implemented to guide primary care providers(PCPs)on use of FibroScan for NAFLD.AIM To analyze how this CDST impacted health care utilization and patient outcomes.METHODS We performed a retrospective review of adults who had FibroScan for NAFLD indication from January 2015 to December 2017(pre-CDST)or January 2018 to December 2020(post-CDST).Outcomes included FibroScan result,laboratory tests,imaging studies,specialty referral,patient morbidity and mortality.RESULTS We identified 958 patients who had FibroScan,115 before and 843 after the CDST was implemented.The percentage of FibroScans ordered by PCPs increased from 33%to 67.1%.The percentage of patients diagnosed with early F1 fibrosis,on a scale from F0 to F4,increased from 7.8%to 14.2%.Those diagnosed with ad-vanced F4 fibrosis decreased from 28.7%to 16.5%.There were fewer laboratory tests,imaging studies and biopsy after the CDST was implemented.Though there were more specialty referrals placed after the CDST was implemented,multivariate analysis revealed that healthcare utilization aligned with fibrosis score,whereby patients with more advanced disease had more referrals.Very few patients were hospitalized or died.CONCLUSION This CDST empowered PCPs to diagnose and manage patients with NAFLD with appropriate allocation of care towards patients with more advanced disease.
文摘In the era of advanced machine learning techniques,the development of accurate predictive models for complex medical conditions,such as thyroid cancer,has shown remarkable progress.Accurate predictivemodels for thyroid cancer enhance early detection,improve resource allocation,and reduce overtreatment.However,the widespread adoption of these models in clinical practice demands predictive performance along with interpretability and transparency.This paper proposes a novel association-rule based feature-integratedmachine learning model which shows better classification and prediction accuracy than present state-of-the-artmodels.Our study also focuses on the application of SHapley Additive exPlanations(SHAP)values as a powerful tool for explaining thyroid cancer prediction models.In the proposed method,the association-rule based feature integration framework identifies frequently occurring attribute combinations in the dataset.The original dataset is used in trainingmachine learning models,and further used in generating SHAP values fromthesemodels.In the next phase,the dataset is integrated with the dominant feature sets identified through association-rule based analysis.This new integrated dataset is used in re-training the machine learning models.The new SHAP values generated from these models help in validating the contributions of feature sets in predicting malignancy.The conventional machine learning models lack interpretability,which can hinder their integration into clinical decision-making systems.In this study,the SHAP values are introduced along with association-rule based feature integration as a comprehensive framework for understanding the contributions of feature sets inmodelling the predictions.The study discusses the importance of reliable predictive models for early diagnosis of thyroid cancer,and a validation framework of explainability.The proposed model shows an accuracy of 93.48%.Performance metrics such as precision,recall,F1-score,and the area under the receiver operating characteristic(AUROC)are also higher than the baseline models.The results of the proposed model help us identify the dominant feature sets that impact thyroid cancer classification and prediction.The features{calcification}and{shape}consistently emerged as the top-ranked features associated with thyroid malignancy,in both association-rule based interestingnessmetric values and SHAPmethods.The paper highlights the potential of the rule-based integrated models with SHAP in bridging the gap between the machine learning predictions and the interpretability of this prediction which is required for real-world medical applications.
文摘AIM To determine clinical scores important for automated calculation in the inpatient setting.METHODS A modified Delphi methodology was used to create consensus of important clinical scores for inpatient practice. A list of 176 externally validated clinical scores were identified from freely available internet-based services frequently used by clinicians. Scores were categorized based on pertinent specialty and a customized survey was created for each clinician specialty group. Clinicians were asked to rank each score based on importance of automated calculation to their clinical practice in three categories-"not important", "nice to have", or "very important". Surveys were solicited via specialty-group listserv over a 3-mo interval. Respondents must have been practicing physicians with more than 20% clinical time spent in the inpatient setting. Within each specialty, consensus was established for any clinical score with greater than 70% of responses in a single category and a minimum of 10 responses. Logistic regression was performed to determine predictors of automation importance.RESULTS Seventy-nine divided by one hundred and forty-four(54.9%) surveys were completed and 72/144(50%) surveys were completed by eligible respondents. Only the critical care and internal medicine specialties surpassed the 10-respondent threshold(14 respondents each). For internists, 2/110(1.8%) of scores were "very important" and 73/110(66.4%) were "nice to have". For intensivists, no scores were "very important" and 26/76(34.2%) were "nice to have". Only the number of medical history(OR = 2.34; 95%CI: 1.26-4.67; P < 0.05) and vital sign(OR = 1.88; 95%CI: 1.03-3.68; P < 0.05) variables for clinical scores used by internists was predictive of desire for automation. CONCLUSION Few clinical scores were deemed "very important" for automated calculation. Future efforts towards score calculator automation should focus on technically feasible "nice to have" scores.
文摘The purpose of this paper is to discuss the development of medical informatization in the era of big data.Through literature review and theoretical analysis,the development of medical informatization in the era of big data is deeply discussed.The results show that medical informatization has developed rapidly in the era of big data,and its role in clinical decision-making,scientific research,teaching,and management has become increasingly prominent.The development of medical informatization in the era of big data has important purposes and methods,which can produce important results and conclusions and provide strong support for the development of the medical field.
基金The authors extend their appreciation to the Deanship of Scientific Research at King Khalid University for funding this work through Small Research Groups under grant number(RGP.1/62/43).
文摘Artificial Intelligence(AI)is finding increasing application in healthcare monitoring.Machine learning systems are utilized for monitoring patient health through the use of IoT sensor,which keep track of the physiological state by way of various health data.Thus,early detection of any disease or derangement can aid doctors in saving patients’lives.However,there are some challenges associated with predicting health status using the common algorithms,such as time requirements,chances of errors,and improper classification.We propose an Artificial Krill Herd based on the Random Forest(AKHRF)technique for monitoring patients’health and eliciting an optimal prescription based on their health status.To begin with,various patient datasets were collected and trained into the system using IoT sensors.As a result,the framework developed includes four processes:preprocessing,feature extraction,classification,and result visibility.Additionally,preprocessing removes errors,noise,and missing values from the dataset,whereas feature extraction extracts the relevant information.Then,in the classification layer,we updated the fitness function of the krill herd to classify the patient’s health status and also generate a prescription.We found that the results fromthe proposed framework are comparable to the results from other state-of-the-art techniques in terms of sensitivity,specificity,Area under the Curve(AUC),accuracy,precision,recall,and F-measure.
文摘Research into medical artificial intelligence(AI)has made significant advances in recent years,including surgical applications.This scoping review investigated AI-based decision support systems targeted at the intraoperative phase of surgery and found a wide range of technological approaches applied across several surgical specialties.Within the twenty-one(n=21)included papers,three main categories of motivations were identified for developing such technologies:(1)augmenting the information available to surgeons,(2)accelerating intraoperative pathology,and(3)recommending surgical steps.While many of the proposals hold promise for improving patient outcomes,important methodological shortcomings were observed in most of the reviewed papers that made it difficult to assess the clinical significance of the reported performance statistics.Despite limitations,the current state of this field suggests that a number of opportunities exist for future researchers and clinicians to work on AI for surgical decision support with exciting implications for improving surgical care.
基金Supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education,No.2018R1D1A1B07041091 and 2021S1A5A8062526.
文摘New technologies such as artificial intelligence,the internet of things,big data,and cloud computing have changed the overall society and economy,and the medical field particularly has tried to combine traditional examination methods and new technologies.The most remarkable field in medical research is the technology of predicting high dementia risk group using big data and artificial intelligence.This review introduces:(1)the definition,main concepts,and classification of machine learning and overall distinction of it from traditional statistical analysis models;and(2)the latest studies in mental science to detect dementia and predict high-risk groups in order to help competent researchers who are challenging medical artificial intelligence in the field of psychiatry.As a result of reviewing 4 studies that used machine learning to discriminate high-risk groups of dementia,various machine learning algorithms such as boosting model,artificial neural network,and random forest were used for predicting dementia.The development of machine learning algorithms will change primary care by applying advanced machine learning algorithms to detect high dementia risk groups in the future.
基金This work was supported by the National Natural Science Foundation of China,[grant number 71171132,61373030].
文摘Treatment plan selection is a complex process because it sometimes needs sufficient experience and clinical information.Nowadays it is even harder for doctors to select an appropriate treatment plan for certain patients since doctors might encounter difficulties in obtaining the right information and analyzing the diverse clinical data.In order to improve the effectiveness of clinical decision making in complicated information system environments,we first propose a linked data-based approach for treatment plan selection.The approach integrates the patients’clinical records in hospitals with open linked data sources out of hospitals.Then,based on the linked data net,treatment plan selection is carried on aided by similar historical therapy cases.Finally,we reorganize the electronic medical records of 97 colon cancer patients using the linked data model and count the similarity of these records to help treatment selecting.The experiment shows the usability of our method in supporting clinical decisions.
基金National High-Tech R&D Program of China(No.2012AA02A601)National Natural Science Foundation of China(No.30900329)
文摘Globally,there is a great gulf between medical knowledge and clinical practice.Translating knowledge into clinical decision support(CDS) application has become the biggest challenge faced by evidence based medicine.This paper proposed a comprehensive motivation framework to facilitate knowledge translation in healthcare.Based on a unified medical knowledge ontology and knowledge base,the framework provides an infrastructure of fundamental services,such as inference service and data acquisition,to support development of knowledge-driven CDS applications and integration into clinical workflow.The framework has been implemented in a 2600-bed Chinese hospital,and is able to reduce the time and cost of developing typical CDS applications.
基金funding support from National Science and Technology Major Project[2018ZX10201002].
文摘The wide use and abuse of antibiotics could make antimicrobial resistance(AMR)an increasingly serious issue that threatens global health and imposes an enormous burden on society and the economy.To avoid the crisis of AMR,we have to fundamentally change our approach.Artificial intelligence(AI)represents a new paradigm to combat AMR.Thus,various AI approaches to this problem have sprung up,some of which may be considered successful cases of domain-specific AI applications in AMR.However,to the best of our knowledge,there is no systematic review illustrating the use of these AI-based applications for AMR.Therefore,this review briefly introduces how to employ AI technology against AMR by using the predictive AMR model,the rational use of antibiotics,antimicrobial peptides(AMPs)and antibiotic combinations,as well as future research directions.
文摘On May 25,2019,the World Health Assembly approved the eleventh revision of the International Statistical Classification of Diseases and Related Health Problems(ICD-11),containing a chapter on traditional medicine.This means that the traditional East Asian medicine(TEAM)is now officially recognized as a part of mainstream medical practice.However,the patterns presented in the ICD-11 traditional medicine chapter are only the tip of the iceberg of TEAM clinical practice,and it will be necessary to supplement and upgrade the contents.In order to implement this,objectification and standardization of TEAM must be premised,and grafting with proper modern science and technology is imperative.Pattern Identification and Prescription Expert-11(PIPE-11),which is a TEAM clinical decision support system,adopts vastly from clinical literature on pattern identification and the prescription.By adopting the rule-based reasoning method,the way of diagnosis and prescription by a TEAM practitioner in actual clinical practice is implemented as it is.PIPE-11 could support to improve both the accuracy of medical diagnosis and the reliability of the medical treatment of TEAM in clinical practices.In the field of research,it might facilitate the usage for reliable reference for symptoms and signs retrieval and patient simulation.In the field of education,it can provide a high level of training for learning pattern identification and prescription,and further be used to reinforce skills of diagnosis and prescription by providing self-simulation methods.Therefore,PIPE-11 as a digital application is expected to support the traditional medicine chapter of ICD-11 to successfully contribute to the improvement of human health.
基金supported by the“Microsoft Grant Award:AI for Health COVID-19″The RISC-19-ICU reg-istry is supported by the Swiss Society of Intensive Care Medicine and funded by internal resources of the Institute of Intensive Care Medicine,of the University Hospital Zurich and by unrestricted grants from CytoSorbents Europe GmbH(Berlin,Germany)+1 种基金Union Bancaire Privée(Zurich,Switzerland)The sponsors had no role in the design of the study,the collection and analysis of the data,or the preparation of the manuscript.
文摘Background:Accurate risk stratification of critically ill patients with coronavirus disease 2019(COVID-19)is essential for optimizing resource allocation,delivering targeted interventions,and maximizing patient survival probability.Machine learning(ML)techniques are attracting increased interest for the development of prediction models as they excel in the analysis of complex signals in data-rich environments such as critical care.Methods:We retrieved data on patients with COVID-19 admitted to an intensive care unit(ICU)between March and October 2020 from the RIsk Stratification in COVID-19 patients in the Intensive Care Unit(RISC-19-ICU)registry.We applied the Extreme Gradient Boosting(XGBoost)algorithm to the data to predict as a binary out-come the increase or decrease in patients’Sequential Organ Failure Assessment(SOFA)score on day 5 after ICU admission.The model was iteratively cross-validated in different subsets of the study cohort.Results:The final study population consisted of 675 patients.The XGBoost model correctly predicted a decrease in SOFA score in 320/385(83%)critically ill COVID-19 patients,and an increase in the score in 210/290(72%)patients.The area under the mean receiver operating characteristic curve for XGBoost was significantly higher than that for the logistic regression model(0.86 vs.0.69,P<0.01[paired t-test with 95%confidence interval]).Conclusions:The XGBoost model predicted the change in SOFA score in critically ill COVID-19 patients admitted to the ICU and can guide clinical decision support systems(CDSSs)aimed at optimizing available resources.
