Artificial intelligence-powered clinical decision making within gastrointestinal surgery: A systematic review.

IF 3.5 2区 医学 Q2 ONCOLOGY Ejso Pub Date : 2025-01-01 Epub Date: 2024-05-11 DOI:10.1016/j.ejso.2024.108385
Mustafa Bektaş, Cevin Tan, George L Burchell, Freek Daams, Donald L van der Peet
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Abstract

Background: Clinical decision-making in gastrointestinal surgery is complex due to the unpredictability of tumoral behavior and postoperative complications. Artificial intelligence (AI) could aid in clinical decision-making by predicting these surgical outcomes. The current status of AI-based clinical decision-making within gastrointestinal surgery is unknown in recent literature. This review aims to provide an overview of AI models used for clinical decision-making within gastrointestinal surgery.

Methods: A systematic literature search was performed in databases PubMed, EMBASE, Cochrane, and Web of Science. To be eligible for inclusion, studies needed to use AI models for clinical decision-making involving patients undergoing gastrointestinal surgery. Studies reporting on reviews, children, and study abstracts were excluded. The Probast risk of bias tool was used to evaluate the methodological quality of AI methods.

Results: Out of 1073 studies, 10 articles were eligible for inclusion. AI models have been used to make clinical decisions between surgical procedures, selection of chemotherapy, selection of postoperative follow up programs, and implementation of a temporary ileostomy. Most studies have used a Random Forest or Gradient Boosting model with AUCs up to 0.97. All studies involved a retrospective study design, in which external validation was performed in one study.

Conclusions: This review shows that AI models have the potentiality to select the most optimal treatments for patients undergoing gastrointestinal surgery. Clinical benefits could be gained if AI models were used for clinical decision-making. However, prospective studies and randomized controlled trials will reveal the definitive role of AI models in clinical decision-making.

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胃肠道手术中的人工智能临床决策:系统综述。
背景:由于肿瘤行为和术后并发症的不可预测性,胃肠道手术的临床决策非常复杂。人工智能(AI)可以通过预测这些手术结果来帮助临床决策。最近的文献中,基于人工智能的胃肠道手术临床决策的现状尚不清楚。本综述旨在概述胃肠道手术中用于临床决策的人工智能模型:在 PubMed、EMBASE、Cochrane 和 Web of Science 等数据库中进行了系统性文献检索。符合纳入条件的研究需要使用人工智能模型对接受胃肠道手术的患者进行临床决策。报告综述、儿童和研究摘要的研究被排除在外。使用 Probast 偏倚风险工具评估人工智能方法的方法学质量:在 1073 项研究中,有 10 篇文章符合纳入条件。人工智能模型已被用于在外科手术、化疗选择、术后随访项目选择和临时回肠造口术实施之间做出临床决策。大多数研究都使用了随机森林或梯度提升模型,其AUC高达0.97。所有研究都采用了回顾性研究设计,其中一项研究进行了外部验证:本综述表明,人工智能模型具有为胃肠道手术患者选择最佳治疗方法的潜力。如果将人工智能模型用于临床决策,将能为临床带来益处。不过,前瞻性研究和随机对照试验将揭示人工智能模型在临床决策中的决定性作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Ejso
Ejso 医学-外科
CiteScore
6.40
自引率
2.60%
发文量
1148
审稿时长
41 days
期刊介绍: JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.
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