Friedrich Sarah, Groß Stefan, König Inke R, Engelhardt Sandy, Bahls Martin, Heinz Judith, Huber Cynthia, Kaderali Lars, Kelm Marcus, Leha Andreas, Rühl Jasmin, Schaller Jens, Scherer Clemens, Vollmer Marcus, Seidler Tim, Friede Tim
Department of Medical Statistics, University Medical Center Göttingen, Humboldtallee 32, 37073 Göttingen, Germany.
Department of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany.
Eur Heart J Digit Health. 2021 Jun 8;2(3):424-436. doi: 10.1093/ehjdh/ztab054. eCollection 2021 Sep.
Artificial intelligence (AI) and machine learning (ML) promise vast advances in medicine. The current state of AI/ML applications in cardiovascular medicine is largely unknown. This systematic review aims to close this gap and provides recommendations for future applications.
Pubmed and EMBASE were searched for applied publications using AI/ML approaches in cardiovascular medicine without limitations regarding study design or study population. The PRISMA statement was followed in this review. A total of 215 studies were identified and included in the final analysis. The majority (87%) of methods applied belong to the context of supervised learning. Within this group, tree-based methods were most commonly used, followed by network and regression analyses as well as boosting approaches. Concerning the areas of application, the most common disease context was coronary artery disease followed by heart failure and heart rhythm disorders. Often, different input types such as electronic health records and images were combined in one AI/ML application. Only a minority of publications investigated reproducibility and generalizability or provided a clinical trial registration.
A major finding is that methodology may overlap even with similar data. Since we observed marked variation in quality, reporting of the evaluation and transparency of data and methods urgently need to be improved.
人工智能(AI)和机器学习(ML)有望在医学领域取得巨大进展。目前AI/ML在心血管医学中的应用状况很大程度上尚不清楚。本系统评价旨在填补这一空白,并为未来的应用提供建议。
在PubMed和EMBASE中检索使用AI/ML方法的心血管医学应用出版物,对研究设计或研究人群没有限制。本评价遵循PRISMA声明。共识别出215项研究并纳入最终分析。应用的方法中大多数(87%)属于监督学习范畴。在这一组中,基于树的方法最常用,其次是网络和回归分析以及增强方法。关于应用领域,最常见的疾病背景是冠状动脉疾病,其次是心力衰竭和心律紊乱。通常,在一个AI/ML应用中会结合不同的输入类型,如电子健康记录和图像。只有少数出版物研究了可重复性和可推广性,或提供了临床试验注册。
一个主要发现是,即使数据相似,方法也可能重叠。由于我们观察到质量存在显著差异,因此迫切需要改进数据和方法评估及透明度的报告。