Taylor R Andrew, Sangal Rohit B, Smith Moira E, Haimovich Adrian D, Rodman Adam, Iscoe Mark S, Pavuluri Suresh K, Rose Christian, Janke Alexander T, Wright Donald S, Socrates Vimig, Declan Arwen
Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Department of Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, Connecticut, USA.
Acad Emerg Med. 2025 Mar;32(3):327-339. doi: 10.1111/acem.15066. Epub 2024 Dec 15.
Diagnostic errors in health care pose significant risks to patient safety and are disturbingly common. In the emergency department (ED), the chaotic and high-pressure environment increases the likelihood of these errors, as emergency clinicians must make rapid decisions with limited information, often under cognitive overload. Artificial intelligence (AI) offers promising solutions to improve diagnostic errors in three key areas: information gathering, clinical decision support (CDS), and feedback through quality improvement. AI can streamline the information-gathering process by automating data retrieval, reducing cognitive load, and providing clinicians with essential patient details quickly. AI-driven CDS systems enhance diagnostic decision making by offering real-time insights, reducing cognitive biases, and prioritizing differential diagnoses. Furthermore, AI-powered feedback loops can facilitate continuous learning and refinement of diagnostic processes by providing targeted education and outcome feedback to clinicians. By integrating AI into these areas, the potential for reducing diagnostic errors and improving patient safety in the ED is substantial. However, successfully implementing AI in the ED is challenging and complex. Developing, validating, and implementing AI as a safe, human-centered ED tool requires thoughtful design and meticulous attention to ethical and practical considerations. Clinicians and patients must be integrated as key stakeholders across these processes. Ultimately, AI should be seen as a tool that assists clinicians by supporting better, faster decisions and thus enhances patient outcomes.
医疗保健中的诊断错误对患者安全构成重大风险,且普遍得令人不安。在急诊科(ED),混乱且高压的环境增加了出现这些错误的可能性,因为急诊临床医生必须在信息有限的情况下迅速做出决策,而且常常处于认知负荷过重的状态。人工智能(AI)在三个关键领域为改善诊断错误提供了有前景的解决方案:信息收集、临床决策支持(CDS)以及通过质量改进提供反馈。人工智能可以通过自动检索数据、减轻认知负担并快速为临床医生提供患者基本信息,来简化信息收集过程。人工智能驱动的临床决策支持系统通过提供实时见解、减少认知偏差以及对鉴别诊断进行优先级排序,来增强诊断决策。此外,人工智能驱动的反馈回路可以通过向临床医生提供有针对性的教育和结果反馈,促进诊断过程的持续学习和优化。通过将人工智能整合到这些领域,在急诊科减少诊断错误和提高患者安全的潜力巨大。然而,在急诊科成功实施人工智能具有挑战性且复杂。将人工智能开发、验证并实施为一种安全、以人为主的急诊科工具,需要精心设计并对伦理和实际考量给予细致关注。临床医生和患者必须作为关键利益相关者融入这些过程。最终,人工智能应被视为一种工具,通过支持更好、更快的决策来协助临床医生,从而改善患者治疗结果。