Hoebers Frank J P, Wee Leonard, Likitlersuang Jirapat, Mak Raymond H, Bitterman Danielle S, Huang Yanqi, Dekker Andre, Aerts Hugo J W L, Kann Benjamin H
Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, MA 02115, United States.
Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, MA 02115, United States.
BJR Open. 2024 Nov 13;6(1):tzae039. doi: 10.1093/bjro/tzae039. eCollection 2024 Jan.
The use of artificial intelligence (AI) holds great promise for radiation oncology, with many applications being reported in the literature, including some of which are already in clinical use. These are mainly in areas where AI provides benefits in efficiency (such as automatic segmentation and treatment planning). Prediction models that directly impact patient decision-making are far less mature in terms of their application in clinical practice. Part of the limited clinical uptake of these models may be explained by the need for broader knowledge, among practising clinicians within the medical community, about the processes of AI development. This lack of understanding could lead to low commitment to AI research, widespread scepticism, and low levels of trust. This attitude towards AI may be further negatively impacted by the perception that deep learning is a "black box" with inherently low transparency. Thus, there is an unmet need to train current and future clinicians in the development and application of AI in medicine. Improving clinicians' AI-related knowledge and skills is necessary to enhance multidisciplinary collaboration between data scientists and physicians, that is, involving a clinician in the loop during AI development. Increased knowledge may also positively affect the acceptance and trust of AI. This paper describes the necessary steps involved in AI research and development, and thus identifies the possibilities, limitations, challenges, and opportunities, as seen from the perspective of a practising radiation oncologist. It offers the clinician with limited knowledge and experience in AI valuable tools to evaluate research papers related to an AI model application.
人工智能(AI)在放射肿瘤学领域具有巨大的应用前景,文献中已报道了许多应用,其中一些已在临床中使用。这些主要集中在AI能提高效率的领域(如自动分割和治疗计划)。直接影响患者决策的预测模型在临床实践中的应用还远不成熟。这些模型在临床应用中受限的部分原因可能是,医学界的执业临床医生需要更广泛地了解AI开发过程。这种理解的缺乏可能导致对AI研究的投入度低、普遍怀疑以及信任度低。深度学习被认为是一个本质上透明度低的“黑匣子”,这种看法可能会进一步对这种对AI的态度产生负面影响。因此,当前和未来的临床医生在医学中AI的开发和应用方面的培训需求尚未得到满足。提高临床医生与AI相关的知识和技能对于加强数据科学家和医生之间的多学科合作是必要的,即在AI开发过程中让临床医生参与其中。知识的增加也可能对AI的接受度和信任度产生积极影响。本文描述了AI研发所涉及的必要步骤,从而从执业放射肿瘤学家的角度确定了可能性、局限性、挑战和机遇。它为在AI方面知识和经验有限的临床医生提供了评估与AI模型应用相关研究论文的宝贵工具。
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