Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
Nat Med. 2019 Mar;25(3):433-438. doi: 10.1038/s41591-018-0335-9. Epub 2019 Feb 11.
Artificial intelligence (AI)-based methods have emerged as powerful tools to transform medical care. Although machine learning classifiers (MLCs) have already demonstrated strong performance in image-based diagnoses, analysis of diverse and massive electronic health record (EHR) data remains challenging. Here, we show that MLCs can query EHRs in a manner similar to the hypothetico-deductive reasoning used by physicians and unearth associations that previous statistical methods have not found. Our model applies an automated natural language processing system using deep learning techniques to extract clinically relevant information from EHRs. In total, 101.6 million data points from 1,362,559 pediatric patient visits presenting to a major referral center were analyzed to train and validate the framework. Our model demonstrates high diagnostic accuracy across multiple organ systems and is comparable to experienced pediatricians in diagnosing common childhood diseases. Our study provides a proof of concept for implementing an AI-based system as a means to aid physicians in tackling large amounts of data, augmenting diagnostic evaluations, and to provide clinical decision support in cases of diagnostic uncertainty or complexity. Although this impact may be most evident in areas where healthcare providers are in relative shortage, the benefits of such an AI system are likely to be universal.
人工智能(AI)方法已经成为改变医疗的强大工具。虽然机器学习分类器(MLC)已经在基于图像的诊断中表现出强大的性能,但分析多样化和大量的电子健康记录(EHR)数据仍然具有挑战性。在这里,我们展示了 MLC 可以以类似于医生使用的假设演绎推理的方式查询 EHR,并发现以前的统计方法没有发现的关联。我们的模型应用了一种使用深度学习技术的自动化自然语言处理系统,从 EHR 中提取临床相关信息。总共分析了来自 1362559 名儿科患者就诊于主要转诊中心的 10160 万数据点,以训练和验证该框架。我们的模型在多个器官系统中表现出高诊断准确性,并且在诊断常见儿科疾病方面与经验丰富的儿科医生相当。我们的研究为实施基于人工智能的系统提供了一个概念验证,作为帮助医生处理大量数据、增强诊断评估以及在诊断不确定或复杂情况下提供临床决策支持的一种手段。虽然这种影响在医疗保健提供者相对短缺的领域可能最为明显,但这种人工智能系统的好处可能是普遍的。