Department of Diagnostic Sciences, Ghent University, Ghent, Belgium.
Department of Nephrology, Ghent University Hospital, Ghent, Belgium.
Crit Rev Clin Lab Sci. 2021 Mar;58(2):131-152. doi: 10.1080/10408363.2020.1828811. Epub 2020 Oct 12.
Machine learning (ML) is gaining increased interest in clinical laboratory medicine, mainly triggered by the decreased cost of generating and storing data using laboratory automation and computational power, and the widespread accessibility of open source tools. Nevertheless, only a handful of ML-based products are currently commercially available for routine clinical laboratory practice. In this review, we start with an introduction to ML by providing an overview of the ML landscape, its general workflow, and the most commonly used algorithms for clinical laboratory applications. Furthermore, we aim to illustrate recent evolutions (2018 to mid-2020) of the techniques used in the clinical laboratory setting and discuss the associated challenges and opportunities. In the field of clinical chemistry, the reviewed applications of ML algorithms include quality review of lab results, automated urine sediment analysis, disease or outcome prediction from routine laboratory parameters, and interpretation of complex biochemical data. In the hematology subdiscipline, we discuss the concepts of automated blood film reporting and malaria diagnosis. At last, we handle a broad range of clinical microbiology applications, such as the reduction of diagnostic workload by laboratory automation, the detection and identification of clinically relevant microorganisms, and the detection of antimicrobial resistance.
机器学习（ML）在临床实验室医学中的应用日益受到关注，主要原因是实验室自动化和计算能力的发展降低了数据生成和存储的成本，并且开源工具的广泛应用使得数据更易获取。然而，目前仅有少数基于 ML 的产品可用于常规临床实验室实践。在这篇综述中，我们首先通过介绍 ML 的概况、其一般工作流程以及临床实验室应用中最常用的算法，来对 ML 进行概述。此外，我们旨在举例说明临床实验室环境中使用的技术的最新进展（2018 年至 2020 年年中），并讨论相关的挑战和机遇。在临床化学领域，我们综述了 ML 算法的应用，包括对实验室结果进行质量审查、自动尿液沉淀物分析、从常规实验室参数预测疾病或结果，以及对复杂生化数据的解释。在血液学亚专业领域，我们讨论了自动血涂片报告和疟疾诊断的概念。最后，我们处理了广泛的临床微生物学应用，例如通过实验室自动化减少诊断工作量、检测和鉴定与临床相关的微生物，以及检测抗菌药物耐药性。
