Schweingruber N, Gerloff C
Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, O10, 2. Stock, 20246, Hamburg, Deutschland.
Nervenarzt. 2021 Feb;92(2):115-126. doi: 10.1007/s00115-020-01050-4. Epub 2021 Jan 24.
Artificial intelligence (AI) has been introduced into medicine and an AI-assisted medicine will be the future that we should help to shape. In particular, supervised, unsupervised, and reinforcement learning will be the main methods to play a role in the implementation of AI. Severely ill patients admitted to the intensive care unit (ICU) are closely monitored in order to be able to quickly respond to any changes. These monitoring data can be used to train AI models to predict critical phases in advance, making an earlier reaction possible. To achieve this a large amount of clinical data are needed in order to train models and an external validation on independent cohorts should take place. Prospective studies with treatment of patients admitted to the ICU with AI assistance should show that they provide a benefit for patients. We present the most important resources from de-identified (anonymized) patient data on open-source use for AI research in intensive care medicine. The focus is on neurological diseases in the ICU, therefore, we provide an overview of existing models for prediction of outcome, vasospasms, intracranial pressure and levels of consciousness. To introduce the advantages of AI in the clinical routine, more AI-based models with larger datasets will be needed. To achieve this international cooperation is absolutely necessary. Clinical centers associated with universities are needed to provide a constant validation of applied models as these models can change during use or a bias can develop during the training. A strong commitment to AI research is important for Germany, not only with respect to academic achievements but also in the light of a rapidly growing influence of AI on the economy.
人工智能(AI)已被引入医学领域,人工智能辅助医学将是我们应助力塑造的未来发展方向。特别是,监督学习、无监督学习和强化学习将成为人工智能应用中的主要方法。重症监护病房(ICU)收治的重症患者会受到密切监测,以便能够对任何变化迅速做出反应。这些监测数据可用于训练人工智能模型,提前预测关键阶段,从而实现更早的应对。为实现这一目标,需要大量临床数据来训练模型,并且应对独立队列进行外部验证。关于在人工智能辅助下治疗ICU收治患者的前瞻性研究应表明,其可为患者带来益处。我们展示了来自去识别(匿名化)患者数据的最重要资源,以供在重症医学领域进行人工智能研究时开源使用。重点是ICU中的神经系统疾病,因此,我们概述了现有的用于预测预后、血管痉挛、颅内压和意识水平的模型。为了在临床常规中引入人工智能的优势,将需要更多基于人工智能且拥有更大数据集的模型。要实现这一点,国际合作绝对必要。需要与大学相关的临床中心持续验证所应用的模型,因为这些模型在使用过程中可能会发生变化,或者在训练过程中可能会产生偏差。对人工智能研究的坚定投入对德国很重要,这不仅关乎学术成就,也鉴于人工智能对经济的影响正在迅速增长。