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脓毒症管理中的人工智能:临床医生概述

Artificial Intelligence in Sepsis Management: An Overview for Clinicians.

作者信息

Bignami Elena Giovanna, Berdini Michele, Panizzi Matteo, Domenichetti Tania, Bezzi Francesca, Allai Simone, Damiano Tania, Bellini Valentina

机构信息

Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Viale Gramsci 14, 43126 Parma, Italy.

出版信息

J Clin Med. 2025 Jan 6;14(1):286. doi: 10.3390/jcm14010286.

Abstract

Sepsis is one of the leading causes of mortality in hospital settings, and early diagnosis is a crucial challenge to improve clinical outcomes. Artificial intelligence (AI) is emerging as a valuable resource to address this challenge, with numerous investigations exploring its application to predict and diagnose sepsis early, as well as personalizing its treatment. Machine learning (ML) models are able to use clinical data collected from hospital Electronic Health Records or continuous monitoring to predict patients at risk of sepsis hours before the onset of symptoms. : Over the past few decades, ML and other AI tools have been explored extensively in sepsis, with models developed for the early detection, diagnosis, prognosis, and even real-time management of treatment strategies. : This review was conducted according to the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research Type) framework to define the study methodology. A critical overview of each paper was conducted by three different reviewers, selecting those that provided original and comprehensive data relevant to the specific topic of the review and contributed significantly to the conceptual or practical framework discussed, without dwelling on technical aspects of the models used. : A total of 194 articles were found; 28 were selected. Articles were categorized and analyzed based on their focus-early prediction, diagnosis, mortality or improvement in the treatment of sepsis. The scientific literature presents mixed outcomes; while some studies demonstrate improvements in mortality rates and clinical management, others highlight challenges, such as a high incidence of false positives and the lack of external validation. This review is designed for clinicians and healthcare professionals, and aims to provide an overview of the application of AI in sepsis management, reviewing the main studies and methodologies used to assess its effectiveness, limitations, and future potential.

摘要

脓毒症是医院环境中主要的死亡原因之一,早期诊断是改善临床结果的一项关键挑战。人工智能(AI)正成为应对这一挑战的宝贵资源,众多研究探索其在早期预测和诊断脓毒症以及个性化治疗方面的应用。机器学习(ML)模型能够利用从医院电子健康记录收集的临床数据或持续监测来在症状出现前数小时预测有脓毒症风险的患者。在过去几十年里,ML和其他AI工具在脓毒症领域得到了广泛探索,开发了用于早期检测、诊断、预后甚至治疗策略实时管理的模型。本综述根据SPIDER(样本、感兴趣现象、设计、评估、研究类型)框架进行,以定义研究方法。由三位不同的评审员对每篇论文进行批判性综述,选择那些提供与综述特定主题相关的原始和全面数据并对所讨论的概念或实践框架有重大贡献的论文,而不纠结于所使用模型的技术方面。共找到194篇文章;选择了28篇。根据文章的重点——脓毒症的早期预测、诊断、死亡率或治疗改善——进行分类和分析。科学文献呈现出喜忧参半的结果;虽然一些研究表明死亡率和临床管理有所改善,但其他研究突出了一些挑战,如假阳性发生率高和缺乏外部验证。本综述是为临床医生和医疗保健专业人员设计的,旨在概述AI在脓毒症管理中的应用,回顾用于评估其有效性、局限性和未来潜力的主要研究和方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b862/11722371/37ece7cb0ca7/jcm-14-00286-g001.jpg

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