Bellini Valentina, Rafano Carnà Emanuele, Russo Michele, Di Vincenzo Fabiola, Berghenti Matteo, Baciarello Marco, Bignami Elena
Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Clinical Engineering Service ("SIC")-AOU Parma, Parma, Italy.
Ann Transl Med. 2022 May;10(9):528. doi: 10.21037/atm-21-7031.
The aim of this narrative review is to analyze whether or not artificial intelligence (AI) and its subsets are implemented in current clinical anesthetic practice, and to describe the current state of the research in the field. AI is a general term which refers to all the techniques that enable computers to mimic human intelligence. AI is based on algorithms that gives machines the ability to reason and perform functions such as problem-solving, object and word recognition, inference of world states, and decision-making. It includes machine learning (ML) and deep learning (DL).
We performed a narrative review of the literature on Scopus, PubMed and Cochrane databases. The research string comprised various combinations of "artificial intelligence", "machine learning", "anesthesia", "anesthesiology". The databases were searched independently by two authors. A third reviewer would mediate any disagreement the results of the two screeners.
The application of AI has shown excellent results in both anesthesia and in operating room (OR) management. In each phase of the perioperative process, pre-, intra- and postoperative ones, it is able to perform different and specific tasks, using various techniques.
Thanks to the use of these new technologies, even anesthesia, as it is happening for other disciplines, is going through a real revolution, called Anesthesia 4.0. However, AI is not free from limitations and open issues. Unfortunately, the models created, provided they have excellent performance, have not yet entered daily practice. Clinical impact analyzes and external validations are needed before this happens. Therefore, qualitative research will be needed to better understand the ethical, cultural, and societal implications of integrating AI into clinical workflows.
本叙述性综述旨在分析人工智能(AI)及其子领域目前是否应用于临床麻醉实践,并描述该领域的研究现状。人工智能是一个通用术语,指的是使计算机能够模仿人类智能的所有技术。人工智能基于算法,赋予机器推理能力并执行诸如解决问题、识别物体和单词、推断世界状态以及决策等功能。它包括机器学习(ML)和深度学习(DL)。
我们对Scopus、PubMed和Cochrane数据库中的文献进行了叙述性综述。检索词包括“人工智能”“机器学习”“麻醉”“麻醉学”的各种组合。由两位作者独立检索数据库。第三位审阅者将协调两位筛选者结果之间的任何分歧。
人工智能在麻醉和手术室(OR)管理中的应用均已显示出优异的效果。在围手术期的每个阶段,即术前、术中和术后,它都能够使用各种技术执行不同的特定任务。
由于这些新技术的应用,即使是麻醉领域,如同其他学科一样,正在经历一场真正的变革,即所谓的“麻醉4.0”。然而,人工智能并非没有局限性和未解决的问题。不幸的是,所创建的模型尽管性能优异,但尚未进入日常实践。在此之前,需要进行临床影响分析和外部验证。因此,需要进行定性研究,以更好地理解将人工智能整合到临床工作流程中的伦理、文化和社会影响。