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基层医疗中基于人工智能的临床决策支持系统:当前临床应用的范围综述

Artificial-Intelligence-Based Clinical Decision Support Systems in Primary Care: A Scoping Review of Current Clinical Implementations.

作者信息

Gomez-Cabello Cesar A, Borna Sahar, Pressman Sophia, Haider Syed Ali, Haider Clifton R, Forte Antonio J

机构信息

Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL 32224, USA.

Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55902, USA.

出版信息

Eur J Investig Health Psychol Educ. 2024 Mar 13;14(3):685-698. doi: 10.3390/ejihpe14030045.

Abstract

Primary Care Physicians (PCPs) are the first point of contact in healthcare. Because PCPs face the challenge of managing diverse patient populations while maintaining up-to-date medical knowledge and updated health records, this study explores the current outcomes and effectiveness of implementing Artificial Intelligence-based Clinical Decision Support Systems (AI-CDSSs) in Primary Healthcare (PHC). Following the PRISMA-ScR guidelines, we systematically searched five databases, PubMed, Scopus, CINAHL, IEEE, and Google Scholar, and manually searched related articles. Only CDSSs powered by AI targeted to physicians and tested in real clinical PHC settings were included. From a total of 421 articles, 6 met our criteria. We found AI-CDSSs from the US, Netherlands, Spain, and China whose primary tasks included diagnosis support, management and treatment recommendations, and complication prediction. Secondary objectives included lessening physician work burden and reducing healthcare costs. While promising, the outcomes were hindered by physicians' perceptions and cultural settings. This study underscores the potential of AI-CDSSs in improving clinical management, patient satisfaction, and safety while reducing physician workload. However, further work is needed to explore the broad spectrum of applications that the new AI-CDSSs have in several PHC real clinical settings and measure their clinical outcomes.

摘要

基层医疗医生是医疗保健中的首要接触点。由于基层医疗医生面临着管理多样化患者群体的挑战,同时还要保持最新的医学知识和更新的健康记录,本研究探讨了在基层医疗(PHC)中实施基于人工智能的临床决策支持系统(AI-CDSSs)的当前成果和有效性。按照PRISMA-ScR指南,我们系统地检索了五个数据库,即PubMed、Scopus、CINAHL、IEEE和谷歌学术,并手动检索了相关文章。仅纳入了由人工智能驱动、针对医生且在基层医疗实际临床环境中进行测试的临床决策支持系统。在总共421篇文章中,有6篇符合我们的标准。我们发现了来自美国、荷兰、西班牙和中国的AI-CDSSs,其主要任务包括诊断支持、管理和治疗建议以及并发症预测。次要目标包括减轻医生的工作负担和降低医疗成本。虽然前景乐观,但这些成果受到医生认知和文化背景的阻碍。本研究强调了AI-CDSSs在改善临床管理、患者满意度和安全性以及减轻医生工作量方面的潜力。然而,需要进一步开展工作,以探索新型AI-CDSSs在多个基层医疗实际临床环境中的广泛应用,并衡量其临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/985d/10969561/968140816bd2/ejihpe-14-00045-g001.jpg

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