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人工智能与单机构关节置换:机器学习在大数据、基于价值的医疗、移动医疗和远程患者监测方面的实际应用。

Artificial Intelligence and Arthroplasty at a Single Institution: Real-World Applications of Machine Learning to Big Data, Value-Based Care, Mobile Health, and Remote Patient Monitoring.

机构信息

Machine Learning Arthroplasty Lab, Cleveland Clinic, Cleveland, OH.

出版信息

J Arthroplasty. 2019 Oct;34(10):2204-2209. doi: 10.1016/j.arth.2019.06.018. Epub 2019 Jun 17.

DOI:10.1016/j.arth.2019.06.018
PMID:31280916
Abstract

BACKGROUND

Driven by the recent ubiquity of big data and computing power, we established the Machine Learning Arthroplasty Laboratory (MLAL) to examine and apply artificial intelligence (AI) to musculoskeletal medicine.

METHODS

In this review, we discuss the 2 core objectives of the MLAL as they relate to the practice and progress of orthopedic surgery: (1) patient-specific, value-based care and (2) human movement.

RESULTS

We developed and validated several machine learning-based models for primary lower extremity arthroplasty that preoperatively predict patient-specific, risk-adjusted value metrics, including cost, length of stay, and discharge disposition, to provide improved expectation management, preoperative planning, and potential financial arbitration. Additionally, we leveraged passive, ubiquitous mobile technologies to build a small data registry of human movement surrounding TKA that permits remote patient monitoring to evaluate therapy compliance, outcomes, opioid intake, mobility, and joint range of motion.

CONCLUSION

The rapid rate with which we in arthroplasty are acquiring and storing continuous data, whether passively or actively, demands an advanced processing approach: AI. By carefully studying AI techniques with the MLAL, we have applied this evolving technique as a first step that may directly improve patient outcomes and practice of orthopedics.

摘要

背景

受大数据和计算能力普及的推动,我们成立了机器学习关节置换实验室(MLAL),以研究和应用人工智能(AI)于肌肉骨骼医学。

方法

在这篇综述中,我们讨论了 MLAL 的 2 个核心目标,它们与矫形外科的实践和进展有关:(1)基于患者个体的、有价值的护理,以及(2)人体运动。

结果

我们开发并验证了几种基于机器学习的初次下肢关节置换模型,这些模型可在术前预测患者个体的、风险调整后的价值指标,包括成本、住院时间和出院去向,以提供更好的预期管理、术前规划和潜在的财务仲裁。此外,我们利用被动的、无处不在的移动技术,建立了一个围绕 TKA 的人体运动的小数据注册表,允许远程患者监测,以评估治疗依从性、结果、阿片类药物摄入、活动能力和关节活动范围。

结论

关节置换术以更快的速度获取和存储连续数据,无论是被动还是主动,这都需要一种先进的处理方法:人工智能。通过在 MLAL 中仔细研究 AI 技术,我们已经应用了这一不断发展的技术作为第一步,这可能直接改善患者的预后和骨科的实践。

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