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成人腹部急症的远程医疗和人工智能管理。

Management of abdominal emergencies in adults using telemedicine and artificial intelligence.

机构信息

Imadis Téléradiologie, Lyon, Bordeaux, Marseille, France; Elsan, Clinique Bouchard, Marseille, France.

Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Service de Chirurgie d'Urgences et Chirurgie Générale, Lyon, France.

出版信息

J Visc Surg. 2021 Jun;158(3S):S26-S31. doi: 10.1016/j.jviscsurg.2021.01.008. Epub 2021 Mar 11.

Abstract

The terms "telemedicine" and "artificial intelligence" (AI) are used today throughout all fields of medicine, with varying degrees of relevance. If telemedicine corresponds to practices currently being developed to supply a high quality response to medical provider shortages in the general provision of healthcare and to specific regional challenges. Through the possibilities of "scalability" and the "augmented physician" that it has helped to create, AI may also constitute a revolution in our practices. In the management of surgical emergencies, abdominal pain is one of the most frequent complaints of patients who present for emergency consultation, and up to 20% of patients prove to have an organic lesion that will require surgical management. In view of the very large number of patients concerned, the variety of clinical presentations, the potential seriousness of the etiological pathology that sometimes involves a life-threatening prognosis, healthcare workers responsible for these patients have logically been led to regularly rely on imaging examinations, which remain the critical key to subsequent management. Therefore, it is not surprising that articles have been published in recent years concerning the potential contributions of telemedicine (and teleradiology) to the diagnostic management of these patients, and also concerning the contribution of AI (albeit still in its infancy) to aid in diagnosis and treatment, including surgery. This review article presents the existing data and proposes a collaborative vision of an optimized patient pathway, giving medical meaning to the use of these tools.

摘要

当今,“远程医疗”和“人工智能”(AI)这两个术语在医学的各个领域都得到了广泛应用,其相关性也不尽相同。远程医疗对应于当前正在开发的实践,旨在为医疗服务提供者在一般医疗保健服务中以及在特定地区的挑战中短缺提供高质量的响应。通过“可扩展性”和它所帮助创造的“增强型医生”的可能性,人工智能也可能成为我们实践的一场革命。在外科急症管理中,腹痛是急诊就诊患者最常见的症状之一,其中多达 20%的患者被证实存在需要手术治疗的器质性病变。鉴于涉及的患者数量非常多,临床表现多种多样,有时涉及危及生命预后的病因病理学的潜在严重性,负责这些患者的医护人员理所当然地定期依赖影像学检查,这些检查仍然是后续管理的关键。因此,近年来发表了一些关于远程医疗(和远程放射学)对这些患者诊断管理的潜在贡献的文章,以及关于人工智能(尽管仍处于起步阶段)在诊断和治疗,包括手术方面的辅助作用的文章,这并不奇怪。本文回顾了现有的数据,并提出了一个优化患者路径的协作愿景,为这些工具的使用赋予医学意义。

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