临床医师机器学习入门。

An Introduction to Machine Learning for Clinicians.

机构信息

M. Rowe is associate professor and departmental chairperson, Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa; ORCID: https://orcid.org/0000-0002-1538-6052.

出版信息

Acad Med. 2019 Oct;94(10):1433-1436. doi: 10.1097/ACM.0000000000002792.

Abstract

The technology at the heart of the most innovative progress in health care artificial intelligence (AI) is in a subdomain called machine learning (ML), which describes the use of software algorithms to identify patterns in very large datasets. ML has driven much of the progress of health care AI over the past 5 years, demonstrating impressive results in clinical decision support, patient monitoring and coaching, surgical assistance, patient care, and systems management. Clinicians in the near future will find themselves working with information networks on a scale well beyond the capacity of human beings to grasp, thereby necessitating the use of intelligent machines to analyze and interpret the complex interactions between data, patients, and clinical decision makers. However, as this technology becomes more powerful, it also becomes less transparent, and algorithmic decisions are therefore progressively more opaque. This is problematic because computers will increasingly be asked for answers to clinical questions that have no single right answer and that are open-ended, subjective, and value laden. As ML continues to make important contributions in a variety of clinical domains, clinicians will need to have a deeper understanding of the design, implementation, and evaluation of ML to ensure that current health care is not overly influenced by the agenda of technology entrepreneurs and venture capitalists. The aim of this article is to provide a nontechnical introduction to the concept of ML in the context of health care, the challenges that arise, and the resulting implications for clinicians.

摘要

医疗人工智能 (AI) 中最具创新性进展的核心技术是机器学习 (ML),它描述了使用软件算法在非常大的数据集识别模式的方法。在过去的 5 年中,ML 推动了医疗 AI 的大部分进展,在临床决策支持、患者监测和指导、手术辅助、患者护理和系统管理方面取得了令人印象深刻的成果。未来的临床医生将发现自己正在使用规模远远超出人类理解能力的信息网络,因此需要使用智能机器来分析和解释数据、患者和临床决策者之间的复杂交互。然而,随着这项技术变得越来越强大,它也变得越来越不透明,因此算法决策也变得越来越不透明。这是一个问题,因为计算机将越来越多地被要求回答没有单一正确答案的临床问题,这些问题是开放式的、主观的和有价值的。随着 ML 在各种临床领域继续做出重要贡献,临床医生需要更深入地了解 ML 的设计、实施和评估,以确保当前的医疗保健不会受到技术企业家和风险投资家议程的过度影响。本文的目的是在医疗保健背景下,对 ML 的概念、出现的挑战以及对临床医生的影响进行非技术性介绍。

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