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比较人工智能检测模型与标准诊断方法及替代模型在识别有风险或早期有症状个体的阿尔茨海默病中的应用:一项范围综述

Comparing the Artificial Intelligence Detection Models to Standard Diagnostic Methods and Alternative Models in Identifying Alzheimer's Disease in At-Risk or Early Symptomatic Individuals: A Scoping Review.

作者信息

Babu Britty, Parvathy Gauri, Mohideen Bawa Fathima S, Gill Gurnoor S, Patel Jeeya, Sibia Dataar S, Sureddi Jayadev, Patel Vidhi

机构信息

Medicine, Tbilisi State Medical University, Tbilisi, GEO.

Medicine, Tbilisi state medical university, Tbilisi, GEO.

出版信息

Cureus. 2024 Dec 9;16(12):e75389. doi: 10.7759/cureus.75389. eCollection 2024 Dec.

Abstract

Alzheimer's disease (AD) and other neurodegenerative illnesses place a heavy strain on the world's healthcare systems, particularly among the aging population. With a focus on research from January 2022 to September 2023, this scoping review, which adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-Scr) criteria, examines the changing landscape of artificial intelligence (AI) applications for early AD detection and diagnosis. Forty-four carefully chosen articles were selected from a pool of 2,966 articles for the qualitative synthesis. The research reveals impressive advancements in AI-driven approaches, including neuroimaging, genomics, cognitive tests, and blood-based biomarkers. Notably, AI models focusing on deep learning (DL) algorithms demonstrate outstanding accuracy in early AD identification, often even before the onset of clinical symptoms. Multimodal approaches, which combine information from various sources, including neuroimaging and clinical assessments, provide comprehensive insights into the complex nature of AD. The study also emphasizes the critical role that blood-based and genetic biomarkers play in strengthening AD diagnosis and risk assessment. When combined with clinical or imaging data, genetic variations and polygenic risk scores help to improve prediction models. In a similar vein, blood-based biomarkers provide non-invasive instruments for detecting metabolic changes linked to AD. Cognitive and functional evaluations, which include neuropsychological examinations and assessments of daily living activities, serve as essential benchmarks for monitoring the course of AD and directing treatment interventions. When these evaluations are included in machine learning models, the diagnosis accuracy is improved, and treatment monitoring is made more accessible. In addition, including methods that support model interpretability and explainability helps in the thorough understanding and valuable implementation of AI-driven insights in clinical contexts. This review further identifies several gaps in the research landscape, including the need for diverse, high-quality datasets to address data heterogeneity and improve model generalizability. Practical implementation challenges, such as integrating AI systems into clinical workflows and clinician adoption, are highlighted as critical barriers to real-world application. Moreover, ethical considerations, particularly surrounding data privacy and informed consent, must be prioritized as AI adoption in healthcare accelerates. Performance metrics (e.g., sensitivity, specificity, and area under the curve (AUC)) for AI-based approaches are discussed, with a need for clearer reporting and comparative analyses. Addressing these limitations, alongside methodological clarity and critical evaluation of biases, would strengthen the credibility of AI applications in AD detection. By expanding its scope, this study highlights areas for improvement and future opportunities in early detection, aiming to bridge the gap between innovative AI technologies and practical clinical utility.

摘要

阿尔茨海默病(AD)和其他神经退行性疾病给全球医疗保健系统带来了沉重负担,在老年人群中尤为突出。本综述聚焦于2022年1月至2023年9月的研究,遵循系统评价和Meta分析扩展的范围综述(PRISMA-Scr)标准,审视了人工智能(AI)在AD早期检测和诊断应用方面不断变化的格局。从2966篇文章中精心挑选了44篇进行定性综合分析。研究揭示了人工智能驱动方法取得的显著进展,包括神经影像学、基因组学、认知测试和血液生物标志物。值得注意的是,专注于深度学习(DL)算法的人工智能模型在AD早期识别中表现出卓越的准确性,往往在临床症状出现之前就能实现。多模态方法结合了来自各种来源的信息,包括神经影像学和临床评估,可以全面洞察AD的复杂本质。该研究还强调了血液和基因生物标志物在加强AD诊断和风险评估方面的关键作用。当与临床或影像数据相结合时,基因变异和多基因风险评分有助于改进预测模型。同样,基于血液的生物标志物为检测与AD相关的代谢变化提供了非侵入性手段。认知和功能评估,包括神经心理学检查和日常生活活动评估,是监测AD病程和指导治疗干预的重要基准。当将这些评估纳入机器学习模型时,诊断准确性会提高,治疗监测也会更便捷。此外,纳入支持模型可解释性的方法有助于在临床环境中全面理解并有效应用人工智能驱动的见解。本综述还指出了研究领域的几个差距,包括需要多样化、高质量的数据集来解决数据异质性并提高模型的通用性。实际应用挑战,如将人工智能系统集成到临床工作流程以及临床医生的接受度,被视为实际应用的关键障碍。此外,随着医疗保健领域加快采用人工智能,伦理考量,特别是围绕数据隐私和知情同意的问题,必须得到优先重视。讨论了基于人工智能方法的性能指标(如敏感性、特异性和曲线下面积(AUC)),需要更清晰的报告和比较分析。克服这些局限性,同时确保方法的清晰度和对偏差的批判性评估,将增强人工智能在AD检测中应用的可信度。通过扩大研究范围,本研究突出了早期检测方面有待改进的领域和未来机遇,旨在弥合创新人工智能技术与实际临床应用之间的差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45c2/11709138/e4c71f22c040/cureus-0016-00000075389-i01.jpg

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