Software & Digital Business Group, Technical University of Darmstadt, Darmstadt, Germany.
J Med Internet Res. 2021 Oct 15;23(10):e29301. doi: 10.2196/29301.
Recently, machine learning (ML) has been transforming our daily lives by enabling intelligent voice assistants, personalized support for purchase decisions, and efficient credit card fraud detection. In addition to its everyday applications, ML holds the potential to improve medicine as well, especially with regard to diagnostics in clinics. In a world characterized by population growth, demographic change, and the global COVID-19 pandemic, ML systems offer the opportunity to make diagnostics more effective and efficient, leading to a high interest of clinics in such systems. However, despite the high potential of ML, only a few ML systems have been deployed in clinics yet, as their adoption process differs significantly from the integration of prior health information technologies given the specific characteristics of ML.
This study aims to explore the factors that influence the adoption process of ML systems for medical diagnostics in clinics to foster the adoption of these systems in clinics. Furthermore, this study provides insight into how these factors can be used to determine the ML maturity score of clinics, which can be applied by practitioners to measure the clinic status quo in the adoption process of ML systems.
To gain more insight into the adoption process of ML systems for medical diagnostics in clinics, we conducted a qualitative study by interviewing 22 selected medical experts from clinics and their suppliers with profound knowledge in the field of ML. We used a semistructured interview guideline, asked open-ended questions, and transcribed the interviews verbatim. To analyze the transcripts, we first used a content analysis approach based on the health care-specific framework of nonadoption, abandonment, scale-up, spread, and sustainability. Then, we drew on the results of the content analysis to create a maturity model for ML adoption in clinics according to an established development process.
With the help of the interviews, we were able to identify 13 ML-specific factors that influence the adoption process of ML systems in clinics. We categorized these factors according to 7 domains that form a holistic ML adoption framework for clinics. In addition, we created an applicable maturity model that could help practitioners assess their current state in the ML adoption process.
Many clinics still face major problems in adopting ML systems for medical diagnostics; thus, they do not benefit from the potential of these systems. Therefore, both the ML adoption framework and the maturity model for ML systems in clinics can not only guide future research that seeks to explore the promises and challenges associated with ML systems in a medical setting but also be a practical reference point for clinicians.
最近,机器学习(ML)通过实现智能语音助手、个性化购买决策支持以及高效的信用卡欺诈检测,正在改变我们的日常生活。除了日常应用外,ML 还有望改善医学,尤其是在临床诊断方面。在人口增长、人口结构变化和全球 COVID-19 大流行的世界中,ML 系统提供了提高诊断效率和效果的机会,这使得临床对这些系统产生了浓厚的兴趣。然而,尽管 ML 具有很高的潜力,但目前只有少数 ML 系统在临床中得到应用,因为与之前的健康信息技术的集成相比,其采用过程存在显著差异,这是由 ML 的特定特征所决定的。
本研究旨在探讨影响 ML 系统在临床诊断中采用的因素,以促进这些系统在临床中的应用。此外,本研究还深入了解如何利用这些因素来确定诊所的 ML 成熟度评分,从业者可以将其应用于衡量 ML 系统采用过程中的诊所现状。
为了更深入地了解 ML 系统在临床诊断中的采用过程,我们对来自临床和具有 ML 领域深厚知识的供应商的 22 名选定的医学专家进行了定性研究。我们使用半结构化访谈指南,提出开放式问题,并逐字记录访谈内容。为了分析转录本,我们首先根据特定于医疗保健的非采用、放弃、扩展、传播和可持续性框架,使用基于内容的分析方法。然后,根据既定的开发过程,我们利用内容分析的结果为临床的 ML 采用创建一个成熟度模型。
通过访谈,我们确定了 13 个影响 ML 系统在临床中采用的 ML 特定因素。我们根据构成临床 ML 采用整体框架的 7 个领域对这些因素进行了分类。此外,我们创建了一个可行的成熟度模型,可帮助从业者评估其在 ML 采用过程中的当前状态。
许多临床仍然面临采用 ML 系统进行医疗诊断的重大问题,因此未能从这些系统的潜力中受益。因此,ML 采用框架和临床 ML 系统的成熟度模型不仅可以指导未来的研究,探索与医疗环境中的 ML 系统相关的承诺和挑战,还可以为临床医生提供实用的参考点。