Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria 3800, Australia.
Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore.
Int J Environ Res Public Health. 2021 Apr 29;18(9):4749. doi: 10.3390/ijerph18094749.
: Little is known about the role of artificial intelligence (AI) as a decisive technology in the clinical management of COVID-19 patients. We aimed to systematically review and critically appraise the current evidence on AI applications for COVID-19 in intensive care and emergency settings. : We systematically searched PubMed, Embase, Scopus, CINAHL, IEEE Xplore, and ACM Digital Library databases from inception to 1 October 2020, without language restrictions. We included peer-reviewed original studies that applied AI for COVID-19 patients, healthcare workers, or health systems in intensive care, emergency, or prehospital settings. We assessed predictive modelling studies and critically appraised the methodology and key findings of all other studies. : Of fourteen eligible studies, eleven developed prognostic or diagnostic AI predictive models, all of which were assessed to be at high risk of bias. Common pitfalls included inadequate sample sizes, poor handling of missing data, failure to account for censored participants, and weak validation of models. : Current AI applications for COVID-19 are not ready for deployment in acute care settings, given their limited scope and poor quality. Our findings underscore the need for improvements to facilitate safe and effective clinical adoption of AI applications, for and beyond the COVID-19 pandemic.
关于人工智能 (AI) 作为 COVID-19 患者临床管理中的决定性技术的作用,目前知之甚少。我们旨在系统地回顾和批判性评估当前关于人工智能在重症监护和急救环境中 COVID-19 应用的证据。
我们系统地检索了 PubMed、Embase、Scopus、CINAHL、IEEE Xplore 和 ACM Digital Library 数据库,从成立到 2020 年 10 月 1 日,没有语言限制。我们纳入了应用人工智能治疗 COVID-19 患者、医护人员或重症监护、急救或院前环境中的卫生系统的同行评审原始研究。我们评估了预测模型研究,并批判性地评估了所有其他研究的方法和关键发现。
在 14 项合格研究中,有 11 项开发了用于 COVID-19 的预测性或诊断性人工智能预测模型,所有这些模型都被评估为存在高偏倚风险。常见的缺陷包括样本量不足、对缺失数据处理不当、未能考虑到被删失的参与者以及模型验证不足。
鉴于其应用范围有限且质量较差,当前用于 COVID-19 的人工智能应用还没有准备好在急性护理环境中部署。我们的研究结果强调需要改进,以促进人工智能应用的安全有效临床应用,不仅在 COVID-19 大流行期间,而且在之后也是如此。