Shixin Yuan, Zihuan Yang, Junjie Li, Changde Wu, Songqiao Liu
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引用次数: 0
摘要
背景:临床恶化之前往往有细微的生理变化,如果不加以注意,可能导致不良的患者结果。传统评分系统在检测这些前体方面的精度存在局限性,这促使人们探索基于人工智能的预测模型,作为提高预测准确性的一种手段,从而提高患者的预后。方法:根据PRISMA指南进行系统评价和荟萃分析。截至2024年4月8日,检索了PubMed、Web of Science等数据库的相关研究。研究是根据预定义的标准选择的,特别是针对基于人工智能的模型,旨在预测院内临床恶化。结果:共有5项研究符合纳入标准,均进行了前瞻性临床验证。这些研究表明,基于人工智能的模型显著降低了住院死亡率和30天死亡率。虽然观察到ICU转移的下降趋势,但结果没有统计学意义。此外,人工智能模型的使用缩短了总体住院时间,但导致ICU住院时间显着增加。结论:研究结果表明,基于人工智能的早期预警模型对现实世界临床环境中的患者预后有积极影响。尽管有潜在的好处,但这些模型的有效性和现实世界的适用性还需要进一步研究。临床医生遵守人工智能警告等挑战仍有待解决。
AI-Powered early warning systems for clinical deterioration significantly improve patient outcomes: a meta-analysis.
Background: Clinical deterioration is often preceded by subtle physiological changes that, if unheeded, can lead to adverse patient outcomes. The precision of traditional scoring systems in detecting these precursors has limitations, prompting the exploration of AI-based predictive models as a means to enhance predictive accuracy and, consequently, patient outcomes.
Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Databases including PubMed, and Web of Science were searched for relevant studies as of April 8, 2024. Studies were selected based on predefined criteria, specifically targeting AI-based models designed to predict in-hospital clinical deterioration.
Results: A total of five studies met the inclusion criteria, all of which underwent prospective clinical validation. These studies demonstrated that AI-based models significantly reduced in-hospital and 30-day mortality rates. Although a downward trend in ICU transfers was observed, the results were not statistically significant. Additionally, the use of AI models shortened overall hospital stays but resulted in a significant increase in ICU length of stay.
Conclusion: The findings suggest that AI-based early warning models positively impact patient outcomes in real-world clinical settings. Despite the potential benefits, the effectiveness and real-world applicability of these models require further research. Challenges such as clinician adherence to AI warnings remain to be addressed.
期刊介绍:
BMC Medical Informatics and Decision Making is an open access journal publishing original peer-reviewed research articles in relation to the design, development, implementation, use, and evaluation of health information technologies and decision-making for human health.