Lupariello Francesco, Sussetto Luca, Di Trani Sara, Di Vella Giancarlo
Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Sezione di Medicina Legale, Università degli Studi di Torino, 10126 Torino, Italy.
Children (Basel). 2023 Oct 6;10(10):1659. doi: 10.3390/children10101659.
All societies should carefully address the child abuse and neglect phenomenon due to its acute and chronic sequelae. Even if artificial intelligence (AI) implementation in this field could be helpful, the state of the art of this implementation is not known. No studies have comprehensively reviewed the types of AI models that have been developed/validated. Furthermore, no indications about the risk of bias in these studies are available. For these reasons, the authors conducted a systematic review of the PubMed database to answer the following questions: "what is the state of the art about the development and/or validation of AI predictive models useful to contrast child abuse and neglect phenomenon?"; "which is the risk of bias of the included articles?". The inclusion criteria were: articles written in English and dated from January 1985 to 31 March 2023; publications that used a medical and/or protective service dataset to develop and/or validate AI prediction models. The reviewers screened 413 articles. Among them, seven papers were included. Their analysis showed that: the types of input data were heterogeneous; artificial neural networks, convolutional neural networks, and natural language processing were used; the datasets had a median size of 2600 cases; the risk of bias was high for all studies. The results of the review pointed out that the implementation of AI in the child abuse and neglect field lagged compared to other medical fields. Furthermore, the evaluation of the risk of bias suggested that future studies should provide an appropriate choice of sample size, validation, and management of overfitting, optimism, and missing data.
由于儿童虐待和忽视现象会产生急性和慢性后遗症,所有社会都应认真应对这一问题。即便在该领域应用人工智能(AI)可能会有所帮助,但目前这种应用的技术水平尚不清楚。尚无研究全面综述已开发/验证的AI模型类型。此外,这些研究中关于偏倚风险的信息也无从获取。出于这些原因,作者对PubMed数据库进行了系统综述,以回答以下问题:“在开发和/或验证有助于应对儿童虐待和忽视现象的AI预测模型方面,目前的技术水平如何?”;“纳入文章的偏倚风险如何?”。纳入标准为:英文撰写且日期在1985年1月至2023年3月31日之间的文章;使用医疗和/或保护服务数据集来开发和/或验证AI预测模型的出版物。评审人员筛选了413篇文章。其中,七篇论文被纳入。他们的分析表明:输入数据类型各异;使用了人工神经网络、卷积神经网络和自然语言处理;数据集的中位数大小为2600个案例;所有研究的偏倚风险都很高。综述结果指出,与其他医学领域相比,AI在儿童虐待和忽视领域的应用较为滞后。此外,对偏倚风险的评估表明,未来的研究应在样本量选择、验证以及对过度拟合、乐观偏差和缺失数据的处理方面做出恰当选择。