Robertson Nicole M, Centner Connor S, Siddharthan Trishul
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
University of Louisville School of Medicine, Louisville, Kentucky, United States.
Chronic Obstr Pulm Dis. 2024 Jan 25;11(1):114-120. doi: 10.15326/jcopdf.2023.0449.
The advancement of artificial intelligence (AI) capabilities has paved the way for a new frontier in medicine, which has the capability to reduce the burden of COPD globally. AI may reduce health care-associated expenses while potentially increasing diagnostic specificity, improving access to early COPD diagnosis, and monitoring COPD progression and subsequent disease management. We evaluated how AI can be integrated into COPD diagnosing globally and leveraged in resource-constrained settings.AI has been explored in diagnosing and phenotyping COPD through auscultation, pulmonary function testing, and imaging. Clinician collaboration with AI has increased the performance of COPD diagnosing and highlights the important role of clinical decision-making in AI integration. Likewise, AI analysis of computer tomography (CT) imaging in large population-based cohorts has increased diagnostic ability, severity classification, and prediction of outcomes related to COPD. Moreover, a multimodality approach with CT imaging, demographic data, and spirometry has been shown to improve machine learning predictions of the progression to COPD compared to each modality alone. Prior research has primarily been conducted in high-income country settings, which may lack generalization to a global population. AI is a World Health Organization priority with the potential to reduce health care barriers in low- and middle-income countries. We recommend a collaboration between clinicians and an AI-supported multimodal approach to COPD diagnosis as a step towards achieving this goal. We believe the interplay of CT imaging, spirometry, biomarkers, and sputum analysis may provide unique insights across settings that could provide a basis for clinical decision-making that includes early intervention for those diagnosed with COPD.
人工智能(AI)能力的进步为医学开辟了一个新领域,其有能力减轻全球慢性阻塞性肺疾病(COPD)的负担。人工智能可能会降低与医疗保健相关的费用,同时有可能提高诊断特异性,改善早期COPD诊断的可及性,并监测COPD的进展及后续疾病管理。我们评估了人工智能如何能在全球范围内整合到COPD诊断中,并在资源有限的环境中加以利用。
人工智能已被用于通过听诊、肺功能测试和成像来诊断COPD并进行表型分析。临床医生与人工智能的合作提高了COPD诊断的性能,并突出了临床决策在人工智能整合中的重要作用。同样,基于大量人群队列的计算机断层扫描(CT)成像的人工智能分析提高了诊断能力、严重程度分类以及与COPD相关的结局预测。此外,与单独使用每种模式相比,采用CT成像、人口统计学数据和肺活量测定的多模式方法已被证明可改善机器学习对COPD进展的预测。先前的研究主要是在高收入国家环境中进行的,可能无法推广到全球人群。人工智能是世界卫生组织的一个优先事项,有潜力减少低收入和中等收入国家的医疗保健障碍。我们建议临床医生与人工智能支持的COPD诊断多模式方法进行合作,以此作为朝着实现这一目标迈出的一步。我们相信,CT成像、肺活量测定、生物标志物和痰液分析之间的相互作用可能会在不同环境中提供独特的见解,从而为临床决策提供依据,包括对那些被诊断为COPD的患者进行早期干预。