Stamm Tanja, Bader-El-Den Mohamed, McNicholas James, Briggs Jim, Zhao Peng
Institute of Outcomes Research, Centre for Medical Data Science, Medical University of Vienna, Vienna, Austria.
Portsmouth AI and Data Science Centre, Faculty of Technology, University of Portsmouth, Portsmouth, United Kingdom.
Front Digit Health. 2025 Aug 5;7:1633458. doi: 10.3389/fdgth.2025.1633458. eCollection 2025.
When a patient survives the first 24 h in intensive care, outcome prediction is crucial for further treatment decisions. As recent advances have shown that Artificial Intelligence (AI) outperforms clinicians in prognostication, and especially generative AI has developed rapidly in the past ten years, this scoping review aimed to explore the use of generative AI models for outcome prediction in intensive care medicine. Of the 481 records found in the search, 119 studies were subjected to abstract screening and, when necessary, full-text review for eligibility assessment. Twenty-two studies and two review articles were finally included. The studies were categorized into three prototypical use cases for generative AI in outcome prediction in intensive care: (i) data augmentation, (ii) feature generation from unstructured data, and (iii) prediction by the generative model. In the first two use cases, the generative models worked together with downstream predictive models. In the third use case, the generative models made the predictions themselves. The studies within data augmentation either fell into the area of compensation for class imbalances by producing additional synthetic cases or imputation of missing values. Overall, Generative Adversarial Network (GAN) was the most frequently used technology (8/22 studies; 36%), followed by Generative Pretrained Transformer (GPT) (7/22 studies; 32%). All publications except one were from the last four years. This review shows that generative AI has immense potential in the future, and continuous monitoring of new technologies is necessary to ensure that patients receive the best possible care.
当患者在重症监护室度过最初24小时后存活下来时,结果预测对于进一步的治疗决策至关重要。由于最近的进展表明,人工智能(AI)在预后预测方面优于临床医生,尤其是生成式AI在过去十年中发展迅速,本综述旨在探讨生成式AI模型在重症医学结果预测中的应用。在检索到的481条记录中,有119项研究进行了摘要筛选,并在必要时进行全文审查以评估其是否符合纳入标准。最终纳入了22项研究和2篇综述文章。这些研究被分为生成式AI在重症监护结果预测中的三个典型用例:(i)数据增强,(ii)从非结构化数据生成特征,以及(iii)由生成模型进行预测。在前两个用例中,生成模型与下游预测模型协同工作。在第三个用例中,生成模型自行进行预测。数据增强方面的研究要么属于通过生成额外的合成病例来补偿类不平衡的领域,要么属于缺失值插补的领域。总体而言,生成对抗网络(GAN)是最常用的技术(8/22项研究;36%),其次是生成式预训练变换器(GPT)(7/22项研究;32%)。除一项研究外,所有出版物均来自过去四年。本综述表明,生成式AI在未来具有巨大潜力,持续监测新技术对于确保患者获得尽可能最佳的护理是必要的。