Theodosiou Anastasia A, Read Robert C
Clinical and Experimental Sciences and NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Tremona Road, SO166YD Southampton, United Kingdom.
Clinical and Experimental Sciences and NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Tremona Road, SO166YD Southampton, United Kingdom.
J Infect. 2023 Oct;87(4):287-294. doi: 10.1016/j.jinf.2023.07.006. Epub 2023 Jul 17.
Artificial intelligence (AI), machine learning and deep learning (including generative AI) are increasingly being investigated in the context of research and management of human infection.
We summarise recent and potential future applications of AI and its relevance to clinical infection practice.
1617 PubMed results were screened, with priority given to clinical trials, systematic reviews and meta-analyses. This narrative review focusses on studies using prospectively collected real-world data with clinical validation, and on research with translational potential, such as novel drug discovery and microbiome-based interventions.
There is some evidence of clinical utility of AI applied to laboratory diagnostics (e.g. digital culture plate reading, malaria diagnosis, antimicrobial resistance profiling), clinical imaging analysis (e.g. pulmonary tuberculosis diagnosis), clinical decision support tools (e.g. sepsis prediction, antimicrobial prescribing) and public health outbreak management (e.g. COVID-19). Most studies to date lack any real-world validation or clinical utility metrics. Significant heterogeneity in study design and reporting limits comparability. Many practical and ethical issues exist, including algorithm transparency and risk of bias.
Interest in and development of AI-based tools for infection research and management are undoubtedly gaining pace, although the real-world clinical utility to date appears much more modest.
人工智能(AI)、机器学习和深度学习(包括生成式AI)在人类感染的研究和管理背景下正受到越来越多的研究。
我们总结了AI的近期及潜在未来应用及其与临床感染实践的相关性。
筛选了1617条PubMed结果,优先考虑临床试验、系统评价和荟萃分析。本叙述性综述重点关注使用前瞻性收集的具有临床验证的真实世界数据的研究,以及具有转化潜力的研究,如新药物发现和基于微生物组的干预措施。
有证据表明AI应用于实验室诊断(如数字培养板读数、疟疾诊断、抗菌药物耐药性分析)、临床影像分析(如肺结核诊断)、临床决策支持工具(如脓毒症预测、抗菌药物处方)和公共卫生疫情管理(如COVID-19)具有临床实用性。迄今为止,大多数研究缺乏任何真实世界验证或临床实用性指标。研究设计和报告中的显著异质性限制了可比性。存在许多实际和伦理问题,包括算法透明度和偏倚风险。
用于感染研究和管理的基于AI的工具的关注度和开发无疑正在加快步伐,尽管迄今为止其真实世界临床实用性似乎要小得多。