Artificial intelligence and prescription of antibiotic therapy: present and future.

IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES
Daniele Roberto Giacobbe, Cristina Marelli, Sabrina Guastavino, Alessio Signori, Sara Mora, Nicola Rosso, Cristina Campi, Michele Piana, Ylenia Murgia, Mauro Giacomini, Matteo Bassetti
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Abstract

Introduction: In the past few years, the use of artificial intelligence in healthcare has grown exponentially. Prescription of antibiotics is not exempt from its rapid diffusion, and various machine learning (ML) techniques, from logistic regression to deep neural networks and large language models, have been explored in the literature to support decisions regarding antibiotic prescription.

Areas covered: In this narrative review, we discuss promises and challenges of the application of ML-based clinical decision support systems (ML-CDSSs) for antibiotic prescription. A search was conducted in PubMed up to April 2024.

Expert opinion: Prescribing antibiotics is a complex process involving various dynamic phases. In each of these phases, the support of ML-CDSSs has shown the potential, and also the actual ability in some studies, to favorably impacting relevant clinical outcomes. Nonetheless, before widely exploiting this massive potential, there are still crucial challenges ahead that are being intensively investigated, pertaining to the transparency of training data, the definition of the sufficient degree of prediction explanations when predictions are obtained through black box models, and the legal and ethical framework for decision responsibility whenever an antibiotic prescription is supported by ML-CDSSs.

人工智能与抗生素治疗处方:现在与未来。
简介过去几年,人工智能在医疗保健领域的应用呈指数级增长。抗生素处方也未能幸免,从逻辑回归到深度神经网络和大型语言模型等各种机器学习(ML)技术已在文献中得到探讨,以支持抗生素处方决策:在这篇叙述性综述中,我们讨论了基于 ML 的临床决策支持系统(ML-CDSS)在抗生素处方方面的应用前景和挑战。在PubMed上进行了搜索,搜索结果截止到2024年4月:抗生素处方是一个复杂的过程,涉及多个动态阶段。在这些阶段中的每一个阶段,ML-CDSS 的支持都显示出对相关临床结果产生有利影响的潜力,在某些研究中也显示出实际能力。然而,在广泛利用这一巨大潜力之前,仍有一些关键的挑战需要深入研究,这些挑战涉及训练数据的透明度、通过黑盒模型获得预测结果时预测解释程度的定义,以及在使用 ML-CDSS 支持抗生素处方时决策责任的法律和伦理框架。
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来源期刊
CiteScore
11.20
自引率
0.00%
发文量
66
审稿时长
4-8 weeks
期刊介绍: Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.
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