Momtazmanesh Sara, Nowroozi Ali, Rezaei Nima
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Rheumatol Ther. 2022 Oct;9(5):1249-1304. doi: 10.1007/s40744-022-00475-4. Epub 2022 Jul 18.
Investigation of the potential applications of artificial intelligence (AI), including machine learning (ML) and deep learning (DL) techniques, is an exponentially growing field in medicine and healthcare. These methods can be critical in providing high-quality care to patients with chronic rheumatological diseases lacking an optimal treatment, like rheumatoid arthritis (RA), which is the second most prevalent autoimmune disease. Herein, following reviewing the basic concepts of AI, we summarize the advances in its applications in RA clinical practice and research. We provide directions for future investigations in this field after reviewing the current knowledge gaps and technical and ethical challenges in applying AI. Automated models have been largely used to improve RA diagnosis since the early 2000s, and they have used a wide variety of techniques, e.g., support vector machine, random forest, and artificial neural networks. AI algorithms can facilitate screening and identification of susceptible groups, diagnosis using omics, imaging, clinical, and sensor data, patient detection within electronic health record (EHR), i.e., phenotyping, treatment response assessment, monitoring disease course, determining prognosis, novel drug discovery, and enhancing basic science research. They can also aid in risk assessment for incidence of comorbidities, e.g., cardiovascular diseases, in patients with RA. However, the proposed models may vary significantly in their performance and reliability. Despite the promising results achieved by AI models in enhancing early diagnosis and management of patients with RA, they are not fully ready to be incorporated into clinical practice. Future investigations are required to ensure development of reliable and generalizable algorithms while they carefully look for any potential source of bias or misconduct. We showed that a growing body of evidence supports the potential role of AI in revolutionizing screening, diagnosis, and management of patients with RA. However, multiple obstacles hinder clinical applications of AI models. Incorporating the machine and/or deep learning algorithms into real-world settings would be a key step in the progress of AI in medicine.
对包括机器学习(ML)和深度学习(DL)技术在内的人工智能(AI)潜在应用的研究,在医学和医疗保健领域正呈指数级增长。对于缺乏最佳治疗方案的慢性风湿性疾病患者,如类风湿关节炎(RA,第二常见的自身免疫性疾病),这些方法对于提供高质量护理可能至关重要。在此,在回顾了AI的基本概念之后,我们总结了其在RA临床实践和研究中的应用进展。在审视了当前应用AI时的知识空白以及技术和伦理挑战后,我们为该领域未来的研究提供了方向。自21世纪初以来,自动化模型已被大量用于改善RA诊断,并且它们使用了各种各样的技术,例如支持向量机、随机森林和人工神经网络。AI算法可促进易感人群的筛查和识别、利用组学、成像、临床和传感器数据进行诊断、在电子健康记录(EHR)中检测患者(即表型分析)、评估治疗反应、监测疾病进程、确定预后、发现新药以及加强基础科学研究。它们还可协助对RA患者发生合并症(如心血管疾病)的风险进行评估。然而,所提出的模型在性能和可靠性方面可能存在显著差异。尽管AI模型在加强RA患者的早期诊断和管理方面取得了令人鼓舞的结果,但它们尚未完全准备好纳入临床实践。未来的研究需要确保开发出可靠且可推广的算法,同时仔细寻找任何潜在的偏差或不当行为来源。我们表明,越来越多的证据支持AI在彻底改变RA患者的筛查、诊断和管理方面的潜在作用。然而,多个障碍阻碍了AI模型的临床应用。将机器学习和/或深度学习算法纳入实际应用场景将是AI在医学领域取得进展的关键一步。