Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Canada.
PLoS One. 2019 Feb 19;14(2):e0212356. doi: 10.1371/journal.pone.0212356. eCollection 2019.
Health care organizations are leveraging machine-learning techniques, such as artificial neural networks (ANN), to improve delivery of care at a reduced cost. Applications of ANN to diagnosis are well-known; however, ANN are increasingly used to inform health care management decisions. We provide a seminal review of the applications of ANN to health care organizational decision-making. We screened 3,397 articles from six databases with coverage of Health Administration, Computer Science and Business Administration. We extracted study characteristics, aim, methodology and context (including level of analysis) from 80 articles meeting inclusion criteria. Articles were published from 1997-2018 and originated from 24 countries, with a plurality of papers (26 articles) published by authors from the United States. Types of ANN used included ANN (36 articles), feed-forward networks (25 articles), or hybrid models (23 articles); reported accuracy varied from 50% to 100%. The majority of ANN informed decision-making at the micro level (61 articles), between patients and health care providers. Fewer ANN were deployed for intra-organizational (meso- level, 29 articles) and system, policy or inter-organizational (macro- level, 10 articles) decision-making. Our review identifies key characteristics and drivers for market uptake of ANN for health care organizational decision-making to guide further adoption of this technique.
医疗保健组织正在利用机器学习技术,如人工神经网络(ANN),以降低成本提供更好的医疗服务。ANN 在诊断中的应用是众所周知的;然而,ANN 也越来越多地被用于为医疗保健管理决策提供信息。我们提供了一个关于 ANN 在医疗保健组织决策中的应用的开创性综述。我们从涵盖卫生管理、计算机科学和商业管理的六个数据库中筛选了 3397 篇文章。我们从符合纳入标准的 80 篇文章中提取了研究特征、目的、方法和背景(包括分析水平)。文章发表于 1997 年至 2018 年,来自 24 个国家,其中大部分(26 篇)文章的作者来自美国。使用的 ANN 类型包括 ANN(36 篇)、前馈网络(25 篇)或混合模型(23 篇);报告的准确率从 50%到 100%不等。大多数 ANN 用于微观层面(61 篇文章)的决策,即患者和医疗保健提供者之间的决策。较少的 ANN 用于组织内部(中观层面,29 篇文章)和系统、政策或组织间(宏观层面,10 篇文章)的决策。我们的综述确定了 ANN 用于医疗保健组织决策的关键特征和市场采用的驱动因素,以指导进一步采用该技术。