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The Lancet. Digital Health Jun 2022Skin cancers occur commonly worldwide. The prognosis and disease burden are highly dependent on the cancer type and disease stage at diagnosis. We systematically... (Review)
Review
Skin cancers occur commonly worldwide. The prognosis and disease burden are highly dependent on the cancer type and disease stage at diagnosis. We systematically reviewed studies on artificial intelligence and machine learning (AI/ML) algorithms that aim to facilitate the early diagnosis of skin cancers, focusing on their application in primary and community care settings. We searched MEDLINE, Embase, Scopus, and Web of Science (from Jan 1, 2000, to Aug 9, 2021) for all studies providing evidence on applying AI/ML algorithms to the early diagnosis of skin cancer, including all study designs and languages. The primary outcome was diagnostic accuracy of the algorithms for skin cancers. The secondary outcomes included an overview of AI/ML methods, evaluation approaches, cost-effectiveness, and acceptability to patients and clinicians. We identified 14 224 studies. Only two studies used data from clinical settings with a low prevalence of skin cancers. We reported data from all 272 studies that could be relevant in primary care. The primary outcomes showed reasonable mean diagnostic accuracy for melanoma (89·5% [range 59·7-100%]), squamous cell carcinoma (85·3% [71·0-97·8%]), and basal cell carcinoma (87·6% [70·0-99·7%]). The secondary outcomes showed a heterogeneity of AI/ML methods and study designs, with high amounts of incomplete reporting (eg, patient demographics and methods of data collection). Few studies used data on populations with a low prevalence of skin cancers to train and test their algorithms; therefore, the widespread adoption into community and primary care practice cannot currently be recommended until efficacy in these populations is shown. We did not identify any health economic, patient, or clinician acceptability data for any of the included studies. We propose a methodological checklist for use in the development of new AI/ML algorithms to detect skin cancer, to facilitate their design, evaluation, and implementation.
Topics: Algorithms; Artificial Intelligence; Early Detection of Cancer; Humans; Machine Learning; Primary Health Care; Skin Neoplasms
PubMed: 35623799
DOI: 10.1016/S2589-7500(22)00023-1 -
Computers in Biology and Medicine Mar 2023Natural Language Processing (NLP) is widely used to extract clinical insights from Electronic Health Records (EHRs). However, the lack of annotated data, automated... (Review)
Review
BACKGROUND
Natural Language Processing (NLP) is widely used to extract clinical insights from Electronic Health Records (EHRs). However, the lack of annotated data, automated tools, and other challenges hinder the full utilisation of NLP for EHRs. Various Machine Learning (ML), Deep Learning (DL) and NLP techniques are studied and compared to understand the limitations and opportunities in this space comprehensively.
METHODOLOGY
After screening 261 articles from 11 databases, we included 127 papers for full-text review covering seven categories of articles: (1) medical note classification, (2) clinical entity recognition, (3) text summarisation, (4) deep learning (DL) and transfer learning architecture, (5) information extraction, (6) Medical language translation and (7) other NLP applications. This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULT AND DISCUSSION
EHR was the most commonly used data type among the selected articles, and the datasets were primarily unstructured. Various ML and DL methods were used, with prediction or classification being the most common application of ML or DL. The most common use cases were: the International Classification of Diseases, Ninth Revision (ICD-9) classification, clinical note analysis, and named entity recognition (NER) for clinical descriptions and research on psychiatric disorders.
CONCLUSION
We find that the adopted ML models were not adequately assessed. In addition, the data imbalance problem is quite important, yet we must find techniques to address this underlining problem. Future studies should address key limitations in studies, primarily identifying Lupus Nephritis, Suicide Attempts, perinatal self-harmed and ICD-9 classification.
Topics: Humans; Natural Language Processing; Electronic Health Records; Machine Learning; Information Storage and Retrieval; Delivery of Health Care
PubMed: 36805219
DOI: 10.1016/j.compbiomed.2023.106649 -
Latest Research Trends in Fall Detection and Prevention Using Machine Learning: A Systematic Review.Sensors (Basel, Switzerland) Jul 2021Falls are unusual actions that cause a significant health risk among older people. The growing percentage of people of old age requires urgent development of fall... (Review)
Review
Falls are unusual actions that cause a significant health risk among older people. The growing percentage of people of old age requires urgent development of fall detection and prevention systems. The emerging technology focuses on developing such systems to improve quality of life, especially for the elderly. A fall prevention system tries to predict and reduce the risk of falls. In contrast, a fall detection system observes the fall and generates a help notification to minimize the consequences of falls. A plethora of technical and review papers exist in the literature with a primary focus on fall detection. Similarly, several studies are relatively old, with a focus on wearables only, and use statistical and threshold-based approaches with a high false alarm rate. Therefore, this paper presents the latest research trends in fall detection and prevention systems using Machine Learning (ML) algorithms. It uses recent studies and analyzes datasets, age groups, ML algorithms, sensors, and location. Additionally, it provides a detailed discussion of the current trends of fall detection and prevention systems with possible future directions. This overview can help researchers understand the current systems and propose new methodologies by improving the highlighted issues.
Topics: Accidental Falls; Aged; Algorithms; Humans; Machine Learning; Quality of Life; Seasons
PubMed: 34372371
DOI: 10.3390/s21155134 -
Pharmaceutical Medicine Oct 2022Artificial intelligence through machine learning uses algorithms and prior learnings to make predictions. Recently, there has been interest to include more artificial...
INTRODUCTION
Artificial intelligence through machine learning uses algorithms and prior learnings to make predictions. Recently, there has been interest to include more artificial intelligence in pharmacovigilance of products already in the market and pharmaceuticals in development.
OBJECTIVE
The aim of this study was to identify and describe the uses of artificial intelligence in pharmacovigilance through a systematic literature review.
METHODS
Embase and MEDLINE database searches were conducted for articles published from January 1, 2015 to July 9, 2021 using search terms such as 'pharmacovigilance,' 'patient safety,' 'artificial intelligence,' and 'machine learning' in the title or abstract. Scientific articles that contained information on the use of artificial intelligence in all modalities of patient safety or pharmacovigilance were reviewed and synthesized using a pre-specified data extraction template. Articles with incomplete information and letters to editor, notes, and commentaries were excluded.
RESULTS
Sixty-six articles were identified for evaluation. Most relevant articles on artificial intelligence focused on machine learning, and it was used in patient safety in the identification of adverse drug events (ADEs) and adverse drug reactions (ADRs) (57.6%), processing safety reports (21.2%), extraction of drug-drug interactions (7.6%), identification of populations at high risk for drug toxicity or guidance for personalized care (7.6%), prediction of side effects (3.0%), simulation of clinical trials (1.5%), and integration of prediction uncertainties into diagnostic classifiers to increase patient safety (1.5%). Artificial intelligence has been used to identify safety signals through automated processes and training with machine learning models; however, the findings may not be generalizable given that there were different types of data included in each source.
CONCLUSION
Artificial intelligence allows for the processing and analysis of large amounts of data and can be applied to various disease states. The automation and machine learning models can optimize pharmacovigilance processes and provide a more efficient way to analyze information relevant to safety, although more research is needed to identify if this optimization has an impact on the quality of safety analyses. It is expected that its use will increase in the near future, particularly with its role in the prediction of side effects and ADRs.
Topics: Artificial Intelligence; Drug-Related Side Effects and Adverse Reactions; Humans; Machine Learning; Pharmaceutical Preparations; Pharmacovigilance
PubMed: 35904529
DOI: 10.1007/s40290-022-00441-z -
Using artificial intelligence methods for systematic review in health sciences: A systematic review.Research Synthesis Methods May 2022The exponential increase in published articles makes a thorough and expedient review of literature increasingly challenging. This review delineated automated tools and...
The exponential increase in published articles makes a thorough and expedient review of literature increasingly challenging. This review delineated automated tools and platforms that employ artificial intelligence (AI) approaches and evaluated the reported benefits and challenges in using such methods. A search was conducted in 4 databases (Medline, Embase, CDSR, and Epistemonikos) up to April 2021 for systematic reviews and other related reviews implementing AI methods. To be included, the review must use any form of AI method, including machine learning, deep learning, neural network, or any other applications used to enable the full or semi-autonomous performance of one or more stages in the development of evidence synthesis. Twelve reviews were included, using nine different tools to implement 15 different AI methods. Eleven methods were used in the screening stages of the review (73%). The rest were divided: two in data extraction (13%) and two in risk of bias assessment (13%). The ambiguous benefits of the data extractions, combined with the reported advantages from 10 reviews, indicating that AI platforms have taken hold with varying success in evidence synthesis. However, the results are qualified by the reliance on the self-reporting of the review authors. Extensive human validation still appears required at this stage in implementing AI methods, though further evaluation is required to define the overall contribution of such platforms in enhancing efficiency and quality in evidence synthesis.
Topics: Humans; Artificial Intelligence; Machine Learning; Medicine; Systematic Reviews as Topic
PubMed: 35174972
DOI: 10.1002/jrsm.1553 -
Artificial Intelligence in Medicine May 2022Cancer is one of the most dangerous diseases to humans, and yet no permanent cure has been developed for it. Breast cancer is one of the most common cancer types.... (Review)
Review
Cancer is one of the most dangerous diseases to humans, and yet no permanent cure has been developed for it. Breast cancer is one of the most common cancer types. According to the National Breast Cancer Foundation, in 2020 alone, more than 276,000 new cases of invasive breast cancer and more than 48,000 non-invasive cases were diagnosed in the US. To put these figures in perspective, 64% of these cases are diagnosed early in the disease's cycle, giving patients a 99% chance of survival. Artificial intelligence and machine learning have been used effectively in detection and treatment of several dangerous diseases, helping in early diagnosis and treatment, and thus increasing the patient's chance of survival. Deep learning has been designed to analyze the most important features affecting detection and treatment of serious diseases. For example, breast cancer can be detected using genes or histopathological imaging. Analysis at the genetic level is very expensive, so histopathological imaging is the most common approach used to detect breast cancer. In this research work, we systematically reviewed previous work done on detection and treatment of breast cancer using genetic sequencing or histopathological imaging with the help of deep learning and machine learning. We also provide recommendations to researchers who will work in this field.
Topics: Artificial Intelligence; Breast Neoplasms; Female; Humans; Machine Learning
PubMed: 35430037
DOI: 10.1016/j.artmed.2022.102276 -
Journal of Medical Internet Research Jul 2019Machine learning (ML) has become a vital part of medical imaging research. ML methods have evolved over the years from manual seeded inputs to automatic initializations....
BACKGROUND
Machine learning (ML) has become a vital part of medical imaging research. ML methods have evolved over the years from manual seeded inputs to automatic initializations. The advancements in the field of ML have led to more intelligent and self-reliant computer-aided diagnosis (CAD) systems, as the learning ability of ML methods has been constantly improving. More and more automated methods are emerging with deep feature learning and representations. Recent advancements of ML with deeper and extensive representation approaches, commonly known as deep learning (DL) approaches, have made a very significant impact on improving the diagnostics capabilities of the CAD systems.
OBJECTIVE
This review aimed to survey both traditional ML and DL literature with particular application for breast cancer diagnosis. The review also provided a brief insight into some well-known DL networks.
METHODS
In this paper, we present an overview of ML and DL techniques with particular application for breast cancer. Specifically, we search the PubMed, Google Scholar, MEDLINE, ScienceDirect, Springer, and Web of Science databases and retrieve the studies in DL for the past 5 years that have used multiview mammogram datasets.
RESULTS
The analysis of traditional ML reveals the limited usage of the methods, whereas the DL methods have great potential for implementation in clinical analysis and improve the diagnostic capability of existing CAD systems.
CONCLUSIONS
From the literature, it can be found that heterogeneous breast densities make masses more challenging to detect and classify compared with calcifications. The traditional ML methods present confined approaches limited to either particular density type or datasets. Although the DL methods show promising improvements in breast cancer diagnosis, there are still issues of data scarcity and computational cost, which have been overcome to a significant extent by applying data augmentation and improved computational power of DL algorithms.
Topics: Breast Neoplasms; Deep Learning; Female; Humans; Machine Learning; Mammography
PubMed: 31350843
DOI: 10.2196/14464 -
Journal of the American Medical... Jan 2022To determine the effects of using unstructured clinical text in machine learning (ML) for prediction, early detection, and identification of sepsis.
OBJECTIVE
To determine the effects of using unstructured clinical text in machine learning (ML) for prediction, early detection, and identification of sepsis.
MATERIALS AND METHODS
PubMed, Scopus, ACM DL, dblp, and IEEE Xplore databases were searched. Articles utilizing clinical text for ML or natural language processing (NLP) to detect, identify, recognize, diagnose, or predict the onset, development, progress, or prognosis of systemic inflammatory response syndrome, sepsis, severe sepsis, or septic shock were included. Sepsis definition, dataset, types of data, ML models, NLP techniques, and evaluation metrics were extracted.
RESULTS
The clinical text used in models include narrative notes written by nurses, physicians, and specialists in varying situations. This is often combined with common structured data such as demographics, vital signs, laboratory data, and medications. Area under the receiver operating characteristic curve (AUC) comparison of ML methods showed that utilizing both text and structured data predicts sepsis earlier and more accurately than structured data alone. No meta-analysis was performed because of incomparable measurements among the 9 included studies.
DISCUSSION
Studies focused on sepsis identification or early detection before onset; no studies used patient histories beyond the current episode of care to predict sepsis. Sepsis definition affects reporting methods, outcomes, and results. Many methods rely on continuous vital sign measurements in intensive care, making them not easily transferable to general ward units.
CONCLUSIONS
Approaches were heterogeneous, but studies showed that utilizing both unstructured text and structured data in ML can improve identification and early detection of sepsis.
Topics: Humans; Machine Learning; Natural Language Processing; Sepsis; Shock, Septic; Vital Signs
PubMed: 34897469
DOI: 10.1093/jamia/ocab236 -
Canadian Association of Radiologists... Nov 2019The required training sample size for a particular machine learning (ML) model applied to medical imaging data is often unknown. The purpose of this study was to provide...
PURPOSE
The required training sample size for a particular machine learning (ML) model applied to medical imaging data is often unknown. The purpose of this study was to provide a descriptive review of current sample-size determination methodologies in ML applied to medical imaging and to propose recommendations for future work in the field.
METHODS
We conducted a systematic literature search of articles using Medline and Embase with keywords including "machine learning," "image," and "sample size." The search included articles published between 1946 and 2018. Data regarding the ML task, sample size, and train-test pipeline were collected.
RESULTS
A total of 167 articles were identified, of which 22 were included for qualitative analysis. There were only 4 studies that discussed sample-size determination methodologies, and 18 that tested the effect of sample size on model performance as part of an exploratory analysis. The observed methods could be categorized as pre hoc model-based approaches, which relied on features of the algorithm, or post hoc curve-fitting approaches requiring empirical testing to model and extrapolate algorithm performance as a function of sample size. Between studies, we observed great variability in performance testing procedures used for curve-fitting, model assessment methods, and reporting of confidence in sample sizes.
CONCLUSIONS
Our study highlights the scarcity of research in training set size determination methodologies applied to ML in medical imaging, emphasizes the need to standardize current reporting practices, and guides future work in development and streamlining of pre hoc and post hoc sample size approaches.
Topics: Biomedical Research; Diagnostic Imaging; Humans; Machine Learning; Sample Size
PubMed: 31522841
DOI: 10.1016/j.carj.2019.06.002 -
Journal of Medical Imaging and... Aug 2021Research in artificial intelligence for radiology and radiotherapy has recently become increasingly reliant on the use of deep learning-based algorithms. While the... (Review)
Review
Research in artificial intelligence for radiology and radiotherapy has recently become increasingly reliant on the use of deep learning-based algorithms. While the performance of the models which these algorithms produce can significantly outperform more traditional machine learning methods, they do rely on larger datasets being available for training. To address this issue, data augmentation has become a popular method for increasing the size of a training dataset, particularly in fields where large datasets aren't typically available, which is often the case when working with medical images. Data augmentation aims to generate additional data which is used to train the model and has been shown to improve performance when validated on a separate unseen dataset. This approach has become commonplace so to help understand the types of data augmentation techniques used in state-of-the-art deep learning models, we conducted a systematic review of the literature where data augmentation was utilised on medical images (limited to CT and MRI) to train a deep learning model. Articles were categorised into basic, deformable, deep learning or other data augmentation techniques. As artificial intelligence models trained using augmented data make their way into the clinic, this review aims to give an insight to these techniques and confidence in the validity of the models produced.
Topics: Deep Learning; Humans; Magnetic Resonance Imaging
PubMed: 34145766
DOI: 10.1111/1754-9485.13261