Department of Neurological Surgery, UC Davis Medical Center, Sacramento, California.
Department of Neurology, Virginia Commonwealth University, Richmond, Virginia.
Semin Neurol. 2024 Jun;44(3):342-356. doi: 10.1055/s-0044-1785504. Epub 2024 Apr 3.
The utilization of Artificial Intelligence (AI) and Machine Learning (ML) is paving the way for significant strides in patient diagnosis, treatment, and prognostication in neurocritical care. These technologies offer the potential to unravel complex patterns within vast datasets ranging from vast clinical data and EEG (electroencephalogram) readings to advanced cerebral imaging facilitating a more nuanced understanding of patient conditions. Despite their promise, the implementation of AI and ML faces substantial hurdles. Historical biases within training data, the challenge of interpreting multifaceted data streams, and the "black box" nature of ML algorithms present barriers to widespread clinical adoption. Moreover, ethical considerations around data privacy and the need for transparent, explainable models remain paramount to ensure trust and efficacy in clinical decision-making.This article reflects on the emergence of AI and ML as integral tools in neurocritical care, discussing their roles from the perspective of both their scientific promise and the associated challenges. We underscore the importance of extensive validation in diverse clinical settings to ensure the generalizability of ML models, particularly considering their potential to inform critical medical decisions such as withdrawal of life-sustaining therapies. Advancement in computational capabilities is essential for implementing ML in clinical settings, allowing for real-time analysis and decision support at the point of care. As AI and ML are poised to become commonplace in clinical practice, it is incumbent upon health care professionals to understand and oversee these technologies, ensuring they adhere to the highest safety standards and contribute to the realization of personalized medicine. This engagement will be pivotal in integrating AI and ML into patient care, optimizing outcomes in neurocritical care through informed and data-driven decision-making.
人工智能 (AI) 和机器学习 (ML) 的应用为神经危重症患者的诊断、治疗和预后提供了重大进展。这些技术有可能从广泛的临床数据和脑电图 (EEG) 读数等复杂数据流中揭示出复杂的模式,从而更深入地了解患者的情况。尽管它们具有很大的潜力,但 AI 和 ML 的实施仍面临着重大障碍。训练数据中的历史偏见、解释多方面数据流的挑战以及 ML 算法的“黑箱”性质,都对其广泛的临床应用构成了障碍。此外,数据隐私的伦理问题以及对透明、可解释模型的需求仍然至关重要,以确保在临床决策中建立信任和有效性。本文从科学前景和相关挑战两个角度探讨了 AI 和 ML 在神经危重症护理中的作用,反映了它们作为不可或缺的工具的出现。我们强调了在不同临床环境中进行广泛验证的重要性,以确保 ML 模型的通用性,特别是考虑到它们有可能为关键医疗决策(如停止维持生命的治疗)提供信息。计算能力的进步对于在临床环境中实施 ML 至关重要,允许在护理点进行实时分析和决策支持。随着 AI 和 ML 准备在临床实践中普及,医疗保健专业人员有责任理解和监督这些技术,确保它们符合最高的安全标准,并为实现个性化医疗做出贡献。这种参与对于将 AI 和 ML 融入患者护理、通过明智和数据驱动的决策优化神经危重症护理的结果将是至关重要的。