AI临床决策工具在结直肠癌多学科小组讨论中的应用。

IF 1.6 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY
Clinics in Colon and Rectal Surgery Pub Date : 2025-12-30 eCollection Date: 2026-05-01 DOI:10.1055/a-2769-1363
Nir Horesh, Anjelli Wignakumar, Sameh Hany Emile
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引用次数: 0

摘要

多学科团队(MDT)讨论已成为结直肠癌(CRC)管理的基石,它整合了外科医生、肿瘤学家、放射科医生、病理学家和联合卫生专业人员的专业知识,以促进个性化、循证护理。然而,治疗选择的复杂性日益增加,特别是随着新辅助策略和免疫疗法的兴起,使得决策更具挑战性。传统的工具——包括临床指南、风险计算器和规律图——提供结构化的决策支持,但缺乏灵活性和个性化。人工智能(AI),特别是通过机器学习(ML)、放射组学和大型语言模型(LLMs),正在成为CRC临床决策的变革性辅助手段。机器学习模型在治疗反应、复发风险和手术并发症方面表现出很强的预测能力,而放射组学和深度学习则通过成像和内窥镜检查提高了诊断准确性和治疗反应预测。在早期的研究中,llm如ChatGPT已显示出与MDT建议的良好一致性,特别是在标准临床情况下。然而,在处理复杂、微妙的案件时,仍然存在局限性。尽管人工智能和法学硕士的能力不断增强,但由于对可解释性、监管监督和道德挑战的担忧,它们尚未集成到常规MDT工作流程中。未来的方向包括开发实时、多模式的AI- mdt平台,提高可解释性,确保公平的数据表示,以及将AI培训整合到医学教育中。本综述概述了目前在CRC MDTs中整合人工智能的证据,强调了其临床潜力和必须解决的障碍,以确保安全、有效和公平地实施。最终,人工智能将增强而不是取代人类的专业知识,增强多学科结直肠癌护理的一致性、效率和个性化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
AI Clinical Decision Tools in Multidisciplinary Team Discussions for Colorectal Cancer.

Multidisciplinary team (MDT) discussions have become a cornerstone of colorectal cancer (CRC) management, integrating the expertise of surgeons, oncologists, radiologists, pathologists, and allied health professionals to facilitate personalized, evidence-based care. However, increasing complexity in treatment options, particularly with the rise of neoadjuvant strategies and immunotherapies, has rendered decision-making more challenging. Traditional tools-including clinical guidelines, risk calculators, and nomograms-offer structured decision support but lack flexibility and personalization. Artificial intelligence (AI), particularly through machine learning (ML), radiomics, and large language models (LLMs), is emerging as a transformative adjunct to clinical decision-making in CRC. Machine learning models have demonstrated strong predictive performance for treatment response, recurrence risk, and surgical complications, while radiomics and deep learning have improved diagnostic accuracy and treatment response prediction using imaging and endoscopy. LLMs such as ChatGPT have shown promising concordance with MDT recommendations in early studies, especially for standard clinical scenarios. However, limitations remain in handling complex, nuanced cases. Despite their growing capabilities, AI and LLMs are not yet integrated into routine MDT workflows due to concerns about interpretability, regulatory oversight, and ethical challenges. Future directions include developing real-time, multimodal AI-MDT platforms, improving explainability, ensuring equitable data representation, and integrating AI training into medical education. This review outlines current evidence on AI integration within CRC MDTs, highlighting both its clinical potential and the barriers that must be addressed to ensure safe, effective, and equitable implementation. Ultimately, AI is poised to augment-not replace-human expertise, enhancing the consistency, efficiency, and personalization of multidisciplinary CRC care.

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来源期刊
Clinics in Colon and Rectal Surgery
Clinics in Colon and Rectal Surgery GASTROENTEROLOGY & HEPATOLOGYSURGERY-SURGERY
CiteScore
2.60
自引率
7.10%
发文量
84
期刊介绍: Clinics in Colon and Rectal Surgery is a review journal that publishes topic-specific issues on diseases of the small bowel, colon, rectum, and anus. Designed for clinicians, researchers, and educators involved with diseases of the intestinal tract, the journal covers a broad spectrum of basic information, controversial clinical issues, and established and innovative diagnostic techniques. Issue topics comprehensively cover the entire specialty over a 3-4 year period, allowing the articles to serve as study material for educational programs and certifying examinations. The inclusion of research and clinical material also allows physicians to remain knowledgeable of current advances in the specialty.
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