Division of Vascular Surgery, Stanford University School of Medicine, 780 Welch Road, CJ350, MC 5639, Palo Alto, CA, 94304.
Division of Cardiovascular Medicine and Cardiovascular Institute, Stanford University, CA.
Semin Vasc Surg. 2023 Sep;36(3):401-412. doi: 10.1053/j.semvascsurg.2023.07.002. Epub 2023 Jul 22.
In the past decade, artificial intelligence (AI)-based applications have exploded in health care. In cardiovascular disease, and vascular surgery specifically, AI tools such as machine learning, natural language processing, and deep neural networks have been applied to automatically detect underdiagnosed diseases, such as peripheral artery disease, abdominal aortic aneurysms, and atherosclerotic cardiovascular disease. In addition to disease detection and risk stratification, AI has been used to identify guideline-concordant statin therapy use and reasons for nonuse, which has important implications for population-based cardiovascular disease health. Although many studies highlight the potential applications of AI, few address true clinical workflow implementation of available AI-based tools. Specific examples, such as determination of optimal statin treatment based on individual patient risk factors and enhancement of intraoperative fluoroscopy and ultrasound imaging, demonstrate the potential promise of AI integration into clinical workflow. Many challenges to AI implementation in health care remain, including data interoperability, model bias and generalizability, prospective evaluation, privacy and security, and regulation. Multidisciplinary and multi-institutional collaboration, as well as adopting a framework for integration, will be critical for the successful implementation of AI tools into clinical practice.
在过去的十年中,基于人工智能 (AI) 的应用在医疗保健领域迅速发展。在心血管疾病,特别是血管外科领域,人工智能工具如机器学习、自然语言处理和深度神经网络已被应用于自动检测外周动脉疾病、腹主动脉瘤和动脉粥样硬化性心血管疾病等未被诊断的疾病。除了疾病检测和风险分层外,人工智能还被用于识别符合指南的他汀类药物治疗的使用情况和未使用的原因,这对基于人群的心血管疾病健康具有重要意义。尽管许多研究强调了人工智能的潜在应用,但很少有研究涉及可用的基于人工智能工具的真正临床工作流程实施。具体示例,如根据个体患者的风险因素确定最佳他汀类药物治疗方案,以及增强术中荧光透视和超声成像,展示了人工智能融入临床工作流程的潜在前景。人工智能在医疗保健中的实施仍然存在许多挑战,包括数据互操作性、模型偏差和通用性、前瞻性评估、隐私和安全以及监管。多学科和多机构合作,以及采用集成框架,对于成功将人工智能工具应用于临床实践至关重要。