Di Bidino Rossella, Piaggio Davide, Andellini Martina, Merino-Barbancho Beatriz, Lopez-Perez Laura, Zhu Tianhui, Raza Zeeshan, Ni Melody, Morrison Andra, Borsci Simone, Fico Giuseppe, Pecchia Leandro, Iadanza Ernesto
Fondazione Policlinico Universitario Agostino Gemelli IRCCS-The Graduate School of Health Economics and Management (ALTEMS), 00168 Rome, Italy.
School of Engineering, University of Warwick, Coventry CV4 7AL, UK.
Bioengineering (Basel). 2023 Sep 22;10(10):1109. doi: 10.3390/bioengineering10101109.
Artificial intelligence and machine learning (AI/ML) are playing increasingly important roles, permeating the field of medical devices (MDs). This rapid progress has not yet been matched by the Health Technology Assessment (HTA) process, which still needs to define a common methodology for assessing AI/ML-based MDs. To collect existing evidence from the literature about the methods used to assess AI-based MDs, with a specific focus on those used for the management of heart failure (HF), the International Federation of Medical and Biological Engineering (IFMBE) conducted a scoping meta-review. This manuscript presents the results of this search, which covered the period from January 1974 to October 2022. After careful independent screening, 21 reviews, mainly conducted in North America and Europe, were retained and included. Among the findings were that deep learning is the most commonly utilised method and that electronic health records and registries are among the most prevalent sources of data for AI/ML algorithms. Out of the 21 included reviews, 19 focused on risk prediction and/or the early diagnosis of HF. Furthermore, 10 reviews provided evidence of the impact on the incidence/progression of HF, and 13 on the length of stay. From an HTA perspective, the main areas requiring improvement are the quality assessment of studies on AI/ML (included in 11 out of 21 reviews) and their data sources, as well as the definition of the criteria used to assess the selection of the most appropriate AI/ML algorithm.
人工智能和机器学习(AI/ML)正在发挥越来越重要的作用,渗透到医疗设备(MD)领域。健康技术评估(HTA)过程尚未跟上这一快速发展的步伐,该过程仍需定义一种评估基于AI/ML的医疗设备的通用方法。为了从文献中收集关于评估基于AI的医疗设备所使用方法的现有证据,特别关注用于心力衰竭(HF)管理的方法,国际医学和生物工程联合会(IFMBE)进行了一项范围界定元综述。本手稿展示了此次检索的结果,检索涵盖了1974年1月至2022年10月期间。经过仔细的独立筛选,保留并纳入了21篇综述,这些综述主要在北美和欧洲进行。研究结果包括深度学习是最常用的方法,电子健康记录和登记处是AI/ML算法最普遍的数据来源。在纳入的21篇综述中,19篇关注HF的风险预测和/或早期诊断。此外,10篇综述提供了对HF发病率/进展影响的证据,13篇提供了对住院时间影响的证据。从HTA的角度来看,需要改进的主要领域是AI/ML研究(21篇综述中有11篇涉及)及其数据源的质量评估,以及用于评估最合适AI/ML算法选择的标准的定义。