Triantafyllidis Andreas K, Tsanas Athanasios
Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece.
Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
J Med Internet Res. 2019 Apr 5;21(4):e12286. doi: 10.2196/12286.
Machine learning has attracted considerable research interest toward developing smart digital health interventions. These interventions have the potential to revolutionize health care and lead to substantial outcomes for patients and medical professionals.
Our objective was to review the literature on applications of machine learning in real-life digital health interventions, aiming to improve the understanding of researchers, clinicians, engineers, and policy makers in developing robust and impactful data-driven interventions in the health care domain.
We searched the PubMed and Scopus bibliographic databases with terms related to machine learning, to identify real-life studies of digital health interventions incorporating machine learning algorithms. We grouped those interventions according to their target (ie, target condition), study design, number of enrolled participants, follow-up duration, primary outcome and whether this had been statistically significant, machine learning algorithms used in the intervention, and outcome of the algorithms (eg, prediction).
Our literature search identified 8 interventions incorporating machine learning in a real-life research setting, of which 3 (37%) were evaluated in a randomized controlled trial and 5 (63%) in a pilot or experimental single-group study. The interventions targeted depression prediction and management, speech recognition for people with speech disabilities, self-efficacy for weight loss, detection of changes in biopsychosocial condition of patients with multiple morbidity, stress management, treatment of phantom limb pain, smoking cessation, and personalized nutrition based on glycemic response. The average number of enrolled participants in the studies was 71 (range 8-214), and the average follow-up study duration was 69 days (range 3-180). Of the 8 interventions, 6 (75%) showed statistical significance (at the P=.05 level) in health outcomes.
This review found that digital health interventions incorporating machine learning algorithms in real-life studies can be useful and effective. Given the low number of studies identified in this review and that they did not follow a rigorous machine learning evaluation methodology, we urge the research community to conduct further studies in intervention settings following evaluation principles and demonstrating the potential of machine learning in clinical practice.
机器学习在开发智能数字健康干预措施方面引起了相当大的研究兴趣。这些干预措施有可能彻底改变医疗保健,并为患者和医疗专业人员带来重大成果。
我们的目的是回顾关于机器学习在现实生活中的数字健康干预措施应用的文献,旨在提高研究人员、临床医生、工程师和政策制定者对在医疗保健领域开发强大且有影响力的数据驱动干预措施的理解。
我们在PubMed和Scopus文献数据库中搜索与机器学习相关的术语,以识别纳入机器学习算法的数字健康干预措施的现实生活研究。我们根据这些干预措施的目标(即目标病症)、研究设计、纳入参与者数量、随访持续时间、主要结局以及该结局是否具有统计学显著性、干预中使用的机器学习算法以及算法的结果(例如预测)对这些干预措施进行分组。
我们的文献检索在现实生活研究中识别出8项纳入机器学习的干预措施,其中3项(37%)在随机对照试验中进行了评估,5项(63%)在试点或实验性单组研究中进行了评估。这些干预措施的目标包括抑郁症预测与管理、言语残疾者的语音识别、减肥的自我效能感、多种疾病患者生物心理社会状况变化的检测、压力管理、幻肢痛治疗、戒烟以及基于血糖反应的个性化营养。研究中纳入参与者的平均数量为71名(范围为8 - 214名),平均随访研究持续时间为69天(范围为3 - 180天)。在这8项干预措施中,6项(75%)在健康结局方面显示出统计学显著性(P = 0.05水平)。
本综述发现,在现实生活研究中纳入机器学习算法的数字健康干预措施可能是有用且有效的。鉴于本综述中识别出的研究数量较少且未遵循严格的机器学习评估方法,我们敦促研究界按照评估原则在干预环境中进行进一步研究,并证明机器学习在临床实践中的潜力。