Antel Ryan, Sahlas Ella, Gore Genevieve, Ingelmo Pablo
Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada.
BJA Open. 2023 Feb 7;5:100125. doi: 10.1016/j.bjao.2023.100125. eCollection 2023 Mar.
Although the development of artificial intelligence (AI) technologies in medicine has been significant, their application to paediatric anaesthesia is not well characterised. As the paediatric operating room is a data-rich environment that requires critical clinical decision-making, this systematic review aims to characterise the current use of AI in paediatric anaesthesia and to identify barriers to the successful integration of such technologies.
This review was registered with PROSPERO (CRD42022304610), the international registry for systematic reviews. The search strategy was prepared by a librarian and run in five electronic databases (Embase, Medline, Central, Scopus, and Web of Science). Collected articles were screened by two reviewers. Included studies described the use of AI for paediatric anaesthesia (<18 yr old) within the perioperative setting.
From 3313 records identified in the initial search, 40 were included in this review. Identified applications of AI were described for patient risk factor prediction (24 studies; 60%), anaesthetic depth estimation (2; 5%), anaesthetic medication/technique decision guidance (2; 5%), intubation assistance (1; 2.5%), airway device selection (3; 7.5%), physiological variable monitoring (6; 15%), and operating room scheduling (2; 5%). Multiple domains of AI were discussed including machine learning, computer vision, fuzzy logic, and natural language processing.
There is an emerging literature regarding applications of AI for paediatric anaesthesia, and their clinical integration holds potential for ultimately improving patient outcomes. However, multiple barriers to their clinical integration remain including a lack of high-quality input data, lack of external validation/evaluation, and unclear generalisability to diverse settings.
CRD42022304610 (PROSPERO).
尽管人工智能(AI)技术在医学领域的发展意义重大,但其在小儿麻醉中的应用尚未得到充分描述。由于儿科手术室是一个数据丰富的环境,需要进行关键的临床决策,本系统评价旨在描述AI在小儿麻醉中的当前应用情况,并确定此类技术成功整合的障碍。
本评价在国际系统评价注册库PROSPERO(CRD42022304610)上进行了注册。检索策略由一名图书馆员制定,并在五个电子数据库(Embase、Medline、Central、Scopus和Web of Science)中运行。收集的文章由两名审阅者进行筛选。纳入的研究描述了AI在围手术期小儿麻醉(<18岁)中的应用。
在初步检索中识别出的3313条记录中,本评价纳入了40条。已识别的AI应用包括患者风险因素预测(24项研究;60%)、麻醉深度估计(2项;5%)、麻醉药物/技术决策指导(2项;5%)、插管辅助(1项;2.5%)、气道装置选择(3项;7.5%)、生理变量监测(6项;15%)和手术室排班(2项;5%)。讨论了AI的多个领域,包括机器学习、计算机视觉、模糊逻辑和自然语言处理。
关于AI在小儿麻醉中的应用有新兴文献,其临床整合最终有可能改善患者结局。然而,其临床整合仍存在多个障碍,包括缺乏高质量的输入数据、缺乏外部验证/评估以及在不同环境中的可推广性不明确。
CRD42022304610(PROSPERO)。