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德国大学医院的未来医学人工智能应用要求和医生期望:基于网络的调查。

Future Medical Artificial Intelligence Application Requirements and Expectations of Physicians in German University Hospitals: Web-Based Survey.

机构信息

Department of Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany.

SMITH Consortium of the German Medical Informatics Initiative, Leipzig, Germany.

出版信息

J Med Internet Res. 2021 Mar 5;23(3):e26646. doi: 10.2196/26646.

Abstract

BACKGROUND

The increasing development of artificial intelligence (AI) systems in medicine driven by researchers and entrepreneurs goes along with enormous expectations for medical care advancement. AI might change the clinical practice of physicians from almost all medical disciplines and in most areas of health care. While expectations for AI in medicine are high, practical implementations of AI for clinical practice are still scarce in Germany. Moreover, physicians' requirements and expectations of AI in medicine and their opinion on the usage of anonymized patient data for clinical and biomedical research have not been investigated widely in German university hospitals.

OBJECTIVE

This study aimed to evaluate physicians' requirements and expectations of AI in medicine and their opinion on the secondary usage of patient data for (bio)medical research (eg, for the development of machine learning algorithms) in university hospitals in Germany.

METHODS

A web-based survey was conducted addressing physicians of all medical disciplines in 8 German university hospitals. Answers were given using Likert scales and general demographic responses. Physicians were asked to participate locally via email in the respective hospitals.

RESULTS

The online survey was completed by 303 physicians (female: 121/303, 39.9%; male: 173/303, 57.1%; no response: 9/303, 3.0%) from a wide range of medical disciplines and work experience levels. Most respondents either had a positive (130/303, 42.9%) or a very positive attitude (82/303, 27.1%) towards AI in medicine. There was a significant association between the personal rating of AI in medicine and the self-reported technical affinity level (H=48.3, P<.001). A vast majority of physicians expected the future of medicine to be a mix of human and artificial intelligence (273/303, 90.1%) but also requested a scientific evaluation before the routine implementation of AI-based systems (276/303, 91.1%). Physicians were most optimistic that AI applications would identify drug interactions (280/303, 92.4%) to improve patient care substantially but were quite reserved regarding AI-supported diagnosis of psychiatric diseases (62/303, 20.5%). Of the respondents, 82.5% (250/303) agreed that there should be open access to anonymized patient databases for medical and biomedical research.

CONCLUSIONS

Physicians in stationary patient care in German university hospitals show a generally positive attitude towards using most AI applications in medicine. Along with this optimism comes several expectations and hopes that AI will assist physicians in clinical decision making. Especially in fields of medicine where huge amounts of data are processed (eg, imaging procedures in radiology and pathology) or data are collected continuously (eg, cardiology and intensive care medicine), physicians' expectations of AI to substantially improve future patient care are high. In the study, the greatest potential was seen in the application of AI for the identification of drug interactions, assumedly due to the rising complexity of drug administration to polymorbid, polypharmacy patients. However, for the practical usage of AI in health care, regulatory and organizational challenges still have to be mastered.

摘要

背景

人工智能(AI)系统在医学领域的日益发展,推动了研究人员和企业家的积极性,同时也对医疗保健的进步寄予了巨大的期望。AI 可能会改变来自几乎所有医学学科和大多数医疗保健领域的医生的临床实践。尽管对医学 AI 的期望很高,但德国实际实施 AI 用于临床实践的情况仍然很少。此外,德国大学医院尚未广泛调查医生对医学 AI 的需求和期望,以及他们对使用匿名患者数据进行临床和生物医学研究的看法。

目的

本研究旨在评估德国大学医院医生对医学 AI 的需求和期望,以及他们对(生物)医学研究中患者数据二次使用的看法(例如,用于开发机器学习算法)。

方法

我们对 8 家德国大学医院的所有医学专业的医生进行了一项基于网络的调查。答案使用李克特量表和一般人口统计学反应给出。医生被要求通过电子邮件在各自的医院参与当地的调查。

结果

该在线调查由来自广泛医学学科和工作经验水平的 303 名医生(女性:121/303,39.9%;男性:173/303,57.1%;无回复:9/303,3.0%)完成。大多数受访者对医学 AI 持积极(130/303,42.9%)或非常积极的态度(82/303,27.1%)。个人对医学 AI 的评价与自我报告的技术亲和力水平之间存在显著关联(H=48.3,P<.001)。绝大多数医生预计未来的医学将是人类和人工智能的混合体(273/303,90.1%),但也要求在常规实施基于 AI 的系统之前进行科学评估(276/303,91.1%)。医生对 AI 应用程序能够识别药物相互作用以显著改善患者护理最为乐观(280/303,92.4%),但对 AI 支持的精神疾病诊断却相当保守(62/303,20.5%)。在受访者中,82.5%(250/303)同意应该为医疗和生物医学研究开放匿名患者数据库。

结论

在德国大学医院接受固定患者护理的医生对在医学中使用大多数 AI 应用程序表现出普遍积极的态度。这种乐观态度伴随着一些期望和希望,即 AI 将帮助医生进行临床决策。特别是在处理大量数据的医学领域(例如放射学和病理学中的成像程序)或连续收集数据的领域(例如心脏病学和重症监护医学),医生对 AI 将大大改善未来患者护理的期望很高。在这项研究中,AI 用于识别药物相互作用的应用被认为具有最大的潜力,因为患有多种疾病和多种药物的患者的药物管理越来越复杂。然而,为了在医疗保健中实际应用 AI,仍需要掌握监管和组织方面的挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2cb/7980122/3459a55a58a1/jmir_v23i3e26646_fig1.jpg

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