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Exploring tele-speech therapy: A scoping review of interventions, applications, benefits, and challenges 探索远程言语治疗:干预、应用、益处和挑战的范围审查。
IF 3.7 2区 医学 Q2 COMPUTER SCIENCE, INFORMATION SYSTEMS Pub Date : 2025-01-08 DOI: 10.1016/j.ijmedinf.2025.105784
Khadijeh Moulaei , Fatemeh Dinari , Mobina Hosseini , Sohrab Almasi , Babak Sabet , Romina Anabestani , Mohammad Reza Afrash

Background

Speech disorders can significantly impact communication, social interaction, and overall quality of life, affecting individuals of all ages. Telespeech therapy has emerged as an innovative solution, leveraging technology to provide accessible and effective speech interventions remotely. This approach offers flexibility and convenience, addressing barriers such as geographical limitations and scheduling conflicts. This review aims to explore key interventions, applications, benefits, and challenges of telespeech therapy to enhance understanding of its potential in improving speech and language outcomes.

Methods

The scoping review was carried out in alignment with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Three electronic databases PubMed, Scopus, and Web of Science were searched. Two authors independently screened and selected the studies.

Results

Of the 2,587 papers, 52 articles were included in our review. Telespeech was most commonly used for treating aphasia (n = 17), stuttering (n = 8), and Parkinson’s disease (n = 6). The primary interventions included videoconferencing (63 %), web-based platforms (24 %), and mobile applications (13 %), with most services delivered synchronously (63 %) and some asynchronously (37 %). The most common applications were “rehabilitation and treatment” (59 %) and “performance assessment of patients”(35 %). A total of 264 tele-speech benefits and challenges were identified and later consolidated into 40 items (26 benefits, 14 challenges). Key benefits included “reliable access to healthcare services and addressing disparities” (n = 26), “cost savings” (n = 23), and “improving patient outcomes and quality of care” (n = 21). Major challenges were “low-speed internet” (n = 13), “lack of technology skills” (n = 11), and “limited access to technology” (n = 8).

Conclusion

Telespeech therapy can be effectively integrated into routine practice, especially in underserved or remote areas. It offers a flexible, cost-effective solution for rehabilitation and performance assessment, improving patient outcomes and addressing healthcare gaps. Continued technological advancements and targeted training can further enhance its benefits and effectiveness.
背景:语言障碍可以显著影响沟通、社会互动和整体生活质量,影响所有年龄段的个体。远程语音治疗已经成为一种创新的解决方案,利用技术提供可访问和有效的远程语音干预。这种方法提供了灵活性和便利性,解决了地理限制和调度冲突等障碍。本文旨在探讨远程语音治疗的主要干预措施、应用、益处和挑战,以加深对其改善语音和语言预后潜力的理解。方法:根据PRISMA-ScR(系统评价和荟萃分析扩展范围评价的首选报告项目)指南进行范围评价。检索了PubMed、Scopus和Web of Science三个电子数据库。两位作者独立筛选和选择了这些研究。结果:2587篇论文中,52篇被纳入我们的综述。远程演讲最常用于治疗失语症(n = 17)、口吃(n = 8)和帕金森病(n = 6)。主要干预措施包括视频会议(63%)、网络平台(24%)和移动应用程序(13%),其中大多数服务同步提供(63%),一些异步提供(37%)。最常见的应用是“康复和治疗”(59%)和“患者绩效评估”(35%)。共确定了264个远程语音利益和挑战,后来将其合并为40个项目(26个利益,14个挑战)。主要益处包括“获得可靠的医疗保健服务和解决差异”(n = 26)、“节省成本”(n = 23)和“改善患者的治疗结果和护理质量”(n = 21)。主要挑战是“网速低”(n = 13)、“缺乏技术技能”(n = 11)和“获取技术的机会有限”(n = 8)。结论:远程语音治疗可以有效地融入日常实践,特别是在服务不足或偏远地区。它为康复和绩效评估提供了一种灵活的、具有成本效益的解决方案,改善了患者的治疗效果,并解决了医疗保健差距。持续的技术进步和有针对性的培训可以进一步提高其效益和有效性。
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引用次数: 0
Impact of the COVID-19 pandemic on mHealth adoption: Identification of the main barriers through an international comparative analysis COVID-19大流行对移动医疗采用的影响:通过国际比较分析确定主要障碍。
IF 3.7 2区 医学 Q2 COMPUTER SCIENCE, INFORMATION SYSTEMS Pub Date : 2025-01-06 DOI: 10.1016/j.ijmedinf.2024.105779
Ana Jiménez-Zarco , Sergio Cámara Mateos , Marina Bosque-Prous , Albert Espelt , Joan Torrent-Sellens , Keyrellous Adib , Karapet Davtyan , Ryan Dos Santos , Francesc Saigí-Rubió

Background

The COVID-19 pandemic greatly challenged health systems worldwide. The adoption and application of mHealth technology emerged as a critical response. However, the permanent implementation and use of such technology faces several barriers, which vary by each country’s innovation level and specific health policies. This study provides a detailed analysis of the transformations in mHealth service implementation within the context of the COVID-19 pandemic.

Objectives

The study analyses the changes to mHealth service implementation during the COVID-19 pandemic. It seeks to identify the main uses of technology in mHealth, to assess their level of adoption, and to address any barriers found. It also aims to compare different countries to understand how factors such as geographical location and public health policies affect mHealth status worldwide.

Methods

The survey tool was a revised version of the World Health Organization (WHO) 2015 Global Survey on eHealth, which had been updated to reflect the latest advances and policy priorities. The 2022 Survey on Digital Health in the WHO European Region was conducted by the WHO between April and October 2022 to gather information from the Member States of that region.

Results

This study shows that across the countries analysed, significant variations occurred in mHealth service adoption during the pandemic. Teleconsultation, access to patient information, and appointment reminders were the most implemented services, highlighting the importance of remote care during health crises. Regional differences were identified regarding barriers such as privacy and security and patient digital literacy, underscoring the need to address such shortcomings. These conclusions have important implications for stakeholders in the digital health sector and emphasise the need for collaboration to address the identified challenges.
背景:2019冠状病毒病大流行给全球卫生系统带来了巨大挑战。移动医疗技术的采用和应用成为关键的应对措施。然而,这些技术的长期实施和使用面临着若干障碍,这些障碍因每个国家的创新水平和具体的卫生政策而异。本研究详细分析了COVID-19大流行背景下移动医疗服务实施的转变。目的:本研究分析了COVID-19大流行期间移动医疗服务实施的变化。它旨在确定移动医疗技术的主要用途,评估其采用程度,并解决发现的任何障碍。它还旨在比较不同的国家,以了解地理位置和公共卫生政策等因素如何影响全球移动健康状况。方法:调查工具是世界卫生组织(WHO) 2015年全球电子卫生调查的修订版,该调查已更新,以反映最新进展和政策重点。世卫组织于2022年4月至10月期间进行了世卫组织欧洲区域2022年数字卫生调查,以收集该区域会员国的信息。结果:本研究表明,在所分析的国家中,大流行期间移动医疗服务的采用发生了显著变化。远程咨询、获取患者信息和预约提醒是实施最多的服务,突出了健康危机期间远程护理的重要性。在隐私和安全以及患者数字素养等障碍方面发现了区域差异,强调需要解决这些缺点。这些结论对数字卫生部门的利益攸关方具有重要意义,并强调需要开展合作,以应对已确定的挑战。
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引用次数: 0
Investigating the role of large language models on questions about refractive surgery 研究大型语言模型在屈光手术问题中的作用。
IF 3.7 2区 医学 Q2 COMPUTER SCIENCE, INFORMATION SYSTEMS Pub Date : 2025-01-06 DOI: 10.1016/j.ijmedinf.2025.105787
Suleyman Demir

Background

Large language models (LLMs) are becoming increasingly popular and are playing an important role in providing accurate clinical information to both patients and physicians. This study aimed to investigate the effectiveness of ChatGPT-4.0, Google Gemini, and Microsoft Copilot LLMs for responding to patient questions regarding refractive surgery.

Methods

The LLMs’ responses to 25 questions about refractive surgery, which are frequently asked by patients, were evaluated by two ophthalmologists using a 5-point Likert scale, with scores ranging from 1 to 5. Furthermore, the DISCERN scale was used to assess the reliability of the language models’ responses, whereas the Flesch Reading Ease and Flesch–Kincaid Grade Level indices were used to evaluate readability.

Results

Significant differences were found among all three LLMs in the Likert scores (p = 0.022). Pairwise comparisons revealed that ChatGPT-4.0′s Likert score was significantly higher than that of Microsoft Copilot, while no significant difference was found when compared to Google Gemini (p = 0.005 and p = 0.087, respectively). In terms of reliability, ChatGPT-4.0 stood out, receiving the highest DISCERN scores among the three LLMs. However, in terms of readability, ChatGPT-4.0 received the lowest score.

Conclusions

ChatGPT-4.0′s responses to inquiries regarding refractive surgery were more intricate for patients compared to other language models; however, the information provided was more dependable and accurate.
背景:大型语言模型(llm)正变得越来越流行,并在为患者和医生提供准确的临床信息方面发挥着重要作用。本研究旨在调查ChatGPT-4.0、谷歌Gemini和Microsoft Copilot llm在回答患者关于屈光手术的问题方面的有效性。方法:两位眼科医生采用李克特5分制对法学硕士对患者常见的25个屈光手术问题的回答进行评估,评分范围为1 ~ 5分。此外,我们使用DISCERN量表来评估语言模型回答的可靠性,而使用Flesch Reading Ease和Flesch- kincaid Grade Level指数来评估可读性。结果:三种LLMs的Likert评分差异有统计学意义(p = 0.022)。两两比较发现,ChatGPT-4.0的Likert评分显著高于Microsoft Copilot,而与谷歌Gemini相比无显著差异(p = 0.005和p = 0.087)。在可靠性方面,ChatGPT-4.0脱颖而出,在三个法学硕士中获得最高的DISCERN分数。然而,在可读性方面,ChatGPT-4.0得分最低。结论:与其他语言模型相比,ChatGPT-4.0对患者关于屈光手术的询问的回答更为复杂;然而,提供的信息更加可靠和准确。
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引用次数: 0
Influencing factors: Unveiling patterns and reasons in telehealth care utilization and adoption/avoidance decisions
IF 3.7 2区 医学 Q2 COMPUTER SCIENCE, INFORMATION SYSTEMS Pub Date : 2025-01-04 DOI: 10.1016/j.ijmedinf.2025.105785
Hinpetch Daungsupawong , Viroj Wiwanitkit
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引用次数: 0
The use of machine learning for the prediction of response to follow-up in spine registries 使用机器学习预测脊柱登记的随访反应。
IF 3.7 2区 医学 Q2 COMPUTER SCIENCE, INFORMATION SYSTEMS Pub Date : 2025-01-03 DOI: 10.1016/j.ijmedinf.2024.105752
Alice Baroncini , Andrea Campagner , Federico Cabitza , Francesco Langella , Francesca Barile , Pablo Bellosta-López , Domenico Compagnone , Riccardo Cecchinato , Marco Damilano , Andrea Redaelli , Daniele Vanni , Pedro Berjano

Background

One of the main challenges in the maintenance of registries is to keep a high follow-up rate and a reliable strategy to limit dropout is currently lacking. Aim of this study was to utilize machine learning (ML) models to highlight the characteristics of patients who are most likely to drop out, and to evaluate the potential cost effectiveness of the implementation of a follow-up system based on the obtained data.

Methods

All patients recruited in the local spine surgery registry were included and demographic, peri- and postoperative data were collected. Five ML models were trained and evaluated for response to follow-up prediction. Explainable and Cautious AI were then implemented to increase the trustworthiness of the model. The efficacy and cost effectiveness of the current follow-up strategy (call everybody) were compared to a strategy based on the implemented model (call only patients with high dropout risk).

Results

Records from 4652 patients were available. The random forest (RF) outperformed all models in the prediction of response to follow-up. Among the considered variables, the ones that had the most weight were length of follow up, level of the main pathology and extent of surgery, SF-36 and BMI. Interpretable Decision Trees (IDT) and selective prediction models further increased the performance of the model. The cost reduction calculation predicted that implementing the developed ML model in the clinical practice would, over time, result in a reduction of costs by 31%, with only 2‰ missed calls.

Conclusion

ML models can effectively identify patients with high risk of dropout. The RF model outperformed all evaluated models, and was further improved with the use of Controllable AI. The application of ML to the follow-up strategy could reduce costs and limit missed responses.
背景:维持登记的主要挑战之一是保持高随访率,目前缺乏可靠的策略来限制辍学。本研究的目的是利用机器学习(ML)模型来突出最有可能退出的患者的特征,并根据获得的数据评估实施随访系统的潜在成本效益。方法:纳入所有在当地脊柱外科登记处招募的患者,收集人口统计学、围手术期和术后数据。对5个ML模型进行训练并评估其对随访预测的响应。然后实施可解释和谨慎的人工智能,以增加模型的可信度。将当前随访策略(呼叫所有人)的疗效和成本效益与基于实施模型的策略(仅呼叫具有高退学风险的患者)进行比较。结果:共有4652例患者记录。随机森林(RF)在预测随访反应方面优于所有模型。在考虑的变量中,权重最大的是随访时间、主要病理程度和手术程度、SF-36和BMI。可解释决策树(IDT)和选择性预测模型进一步提高了模型的性能。成本降低计算预测,随着时间的推移,在临床实践中实施开发的ML模型将使成本降低31%,未接来电率仅为2‰。结论:ML模型能有效识别辍学高危患者。RF模型优于所有评估模型,并通过使用可控AI进一步改进。将机器学习应用于后续策略可以降低成本并限制错过的响应。
{"title":"The use of machine learning for the prediction of response to follow-up in spine registries","authors":"Alice Baroncini ,&nbsp;Andrea Campagner ,&nbsp;Federico Cabitza ,&nbsp;Francesco Langella ,&nbsp;Francesca Barile ,&nbsp;Pablo Bellosta-López ,&nbsp;Domenico Compagnone ,&nbsp;Riccardo Cecchinato ,&nbsp;Marco Damilano ,&nbsp;Andrea Redaelli ,&nbsp;Daniele Vanni ,&nbsp;Pedro Berjano","doi":"10.1016/j.ijmedinf.2024.105752","DOIUrl":"10.1016/j.ijmedinf.2024.105752","url":null,"abstract":"<div><h3>Background</h3><div>One of the main challenges in the maintenance of registries is to keep a high follow-up rate and a reliable strategy to limit dropout is currently lacking. Aim of this study was to utilize machine learning (ML) models to highlight the characteristics of patients who are most likely to drop out, and to evaluate the potential cost effectiveness of the implementation of a follow-up system based on the obtained data.</div></div><div><h3>Methods</h3><div>All patients recruited in the local spine surgery registry were included and demographic, peri- and postoperative data were collected. Five ML models were trained and evaluated for response to follow-up prediction. Explainable and Cautious AI were then implemented to increase the trustworthiness of the model. The efficacy and cost effectiveness of the current follow-up strategy (call everybody) were compared to a strategy based on the implemented model (call only patients with high dropout risk).</div></div><div><h3>Results</h3><div>Records from 4652 patients were available. The random forest (RF) outperformed all models in the prediction of response to follow-up. Among the considered variables, the ones that had the most weight were length of follow up, level of the main pathology and extent of surgery, SF-36 and BMI. Interpretable Decision Trees (IDT) and selective prediction models further increased the performance of the model. The cost reduction calculation predicted that implementing the developed ML model in the clinical practice would, over time, result in a reduction of costs by 31%, with only 2‰ missed calls.</div></div><div><h3>Conclusion</h3><div>ML models can effectively identify patients with high risk of dropout. The RF model outperformed all evaluated models, and was further improved with the use of Controllable AI. The application of ML to the follow-up strategy could reduce costs and limit missed responses.</div></div>","PeriodicalId":54950,"journal":{"name":"International Journal of Medical Informatics","volume":"195 ","pages":"Article 105752"},"PeriodicalIF":3.7,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ATC-to-RxNorm mappings – A comparison between OHDSI Standardized Vocabularies and UMLS Metathesaurus atc到rxnorm的映射——OHDSI标准化词汇表和uml元词汇表之间的比较。
IF 3.7 2区 医学 Q2 COMPUTER SCIENCE, INFORMATION SYSTEMS Pub Date : 2024-12-31 DOI: 10.1016/j.ijmedinf.2024.105777
Rowdy de Groot , Savannah Glaser , Alexandra Kogan , Stephanie Medlock , Anna Alloni , Matteo Gabetta , Szymon Wilk , Nicolette de Keizer , Ronald Cornet

Introduction

The World Health Organization global standard for representing drug data is the Anatomical Therapeutic Chemical (ATC) classification. However, it does not represent ingredients and other drug properties required by clinical decision support systems. A mapping to a terminology system that contains this information, like RxNorm, may help fill this gap. This work evaluates and compares the completeness of mappings from the chemical substance level (5th-level) ATC classes to RxNorm ingredient concepts in the OHDSI Standardized Vocabularies (OSV) and the Unified Medical Language System (UMLS) Metathesaurus.

Methods

To check the concordance between OSV and UMLS we compared the included contents of ATC and RxNorm not only in OSV and UMLS but also in BioPortal and the National Library of Medicine (NLM) repository. For each repository, we determined the number of 5th-level ATC concepts, RxNorm ingredient concepts, missing classes and concepts, and the ATC categories with the most missing concepts. The mappings from ATC to RxNorm in OSV and UMLS were compared, and we determined the number of mappings in common, and the mapping differences, which we categorized. We applied the mappings from OSV and UMLS on a sample of Electronic Health Record (EHR) data.

Results

NLM contained the most ATC and RxNorm concepts. UMLS contained more missing mappings (null mappings) than OSV, 1949 versus 916. Most mapping differences were in the “unknown ingredient in the ATC label” category, for which UMLS provided no mappings. UMLS had a higher coverage of mappings in the sample EHR data than OSV, 96.5% versus 91%.

Discussion

In conclusion, opting for OSV rather than UMLS is generally preferable for an ATC to RxNorm mapping since OSV provides more mappings. However, the results of the sample data show that UMLS can have fewer null mappings in concrete applications.
介绍:世界卫生组织表示药物数据的全球标准是解剖治疗化学(ATC)分类。然而,它并不代表临床决策支持系统所需的成分和其他药物特性。映射到包含此信息的术语系统(如RxNorm)可能有助于填补这一空白。这项工作评估并比较了OHDSI标准化词汇表(OSV)和统一医学语言系统(UMLS)元词典中从化学物质级(第5级)ATC类到RxNorm成分概念的映射的完整性。方法:比较OSV和UMLS中ATC和RxNorm的收录内容以及BioPortal和美国国家医学图书馆(National Library of Medicine, NLM)资料库中ATC和RxNorm的收录内容,以检验两者的一致性。对于每个存储库,我们确定了第5级ATC概念、RxNorm成分概念、缺失类和概念的数量,以及缺失概念最多的ATC类别的数量。比较了OSV和UMLS中从ATC到RxNorm的映射,我们确定了常见映射的数量,以及映射的差异,并对其进行了分类。我们将来自OSV和UMLS的映射应用于电子健康记录(EHR)数据样本。结果:NLM包含的ATC和RxNorm概念最多。UMLS比OSV, 1949和916包含更多的缺失映射(空映射)。大多数映射差异是在“ATC标签中的未知成分”类别中,对此UMLS没有提供映射。UMLS在样本EHR数据中的映射覆盖率高于OSV,分别为96.5%和91%。讨论:总之,选择OSV而不是UMLS通常更适合ATC到RxNorm的映射,因为OSV提供了更多的映射。然而,样本数据的结果表明,在具体的应用程序中,UMLS可以有更少的空映射。
{"title":"ATC-to-RxNorm mappings – A comparison between OHDSI Standardized Vocabularies and UMLS Metathesaurus","authors":"Rowdy de Groot ,&nbsp;Savannah Glaser ,&nbsp;Alexandra Kogan ,&nbsp;Stephanie Medlock ,&nbsp;Anna Alloni ,&nbsp;Matteo Gabetta ,&nbsp;Szymon Wilk ,&nbsp;Nicolette de Keizer ,&nbsp;Ronald Cornet","doi":"10.1016/j.ijmedinf.2024.105777","DOIUrl":"10.1016/j.ijmedinf.2024.105777","url":null,"abstract":"<div><h3>Introduction</h3><div>The World Health Organization global standard for representing drug data is the Anatomical Therapeutic Chemical (ATC) classification. However, it does not represent ingredients and other drug properties required by clinical decision support systems. A mapping to a terminology system that contains this information, like RxNorm, may help fill this gap. This work evaluates and compares the completeness of mappings from the chemical substance level (5th-level) ATC classes to RxNorm ingredient concepts in the OHDSI Standardized Vocabularies (OSV) and the Unified Medical Language System (UMLS) Metathesaurus.</div></div><div><h3>Methods</h3><div>To check the concordance between OSV and UMLS we compared the included contents of ATC and RxNorm not only in OSV and UMLS but also in BioPortal and the National Library of Medicine (NLM) repository. For each repository, we determined the number of 5th-level ATC concepts, RxNorm ingredient concepts, missing classes and concepts, and the ATC categories with the most missing concepts. The mappings from ATC to RxNorm in OSV and UMLS were compared, and we determined the number of mappings in common, and the mapping differences, which we categorized. We applied the mappings from OSV and UMLS on a sample of Electronic Health Record (EHR) data.</div></div><div><h3>Results</h3><div>NLM contained the most ATC and RxNorm concepts. UMLS contained more missing mappings (null mappings) than OSV, 1949 versus 916. Most mapping differences were in the “unknown ingredient in the ATC label” category, for which UMLS provided no mappings. UMLS had a higher coverage of mappings in the sample EHR data than OSV, 96.5% versus 91%.</div></div><div><h3>Discussion</h3><div>In conclusion, opting for OSV rather than UMLS is generally preferable for an ATC to RxNorm mapping since OSV provides more mappings. However, the results of the sample data show that UMLS can have fewer null mappings in concrete applications.</div></div>","PeriodicalId":54950,"journal":{"name":"International Journal of Medical Informatics","volume":"195 ","pages":"Article 105777"},"PeriodicalIF":3.7,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Knowledge domain and frontier trends of artificial intelligence applied in solid organ transplantation: A visualization analysis
IF 3.7 2区 医学 Q2 COMPUTER SCIENCE, INFORMATION SYSTEMS Pub Date : 2024-12-31 DOI: 10.1016/j.ijmedinf.2024.105782
Miao Gong , Yingsong Jiang , Yingshuo Sun , Rui Liao , Yanyao Liu , Zikang Yan , Aiting He , Mingming Zhou , Jie Yang , Yongzhong Wu , Zhongjun Wu , ZuoTian Huang , Hao Wu , Liqing Jiang

Background

Solid organ transplantation (SOT) is vital for end-stage organ failure but faces challenges like organ shortage and rejection. Artificial intelligence (AI) offers potential to improve outcomes through better matching, success prediction, and automation. However, the evolution of AI in SOT research remains underexplored. This study uses bibliometric analysis to identify trends, hotspots, and key contributors in the field.

Methods

821 articles from the Web of Science Core Collection were exported for analysis. Microsoft Excel 2021 was used for descriptive statistics. VOSviewer, CiteSpace, Scimago Graphica, and Biblioshiny were used for bibliometric analysis. The ggalluvial package in R was utilized to create Sankey diagrams, and top articles were selected based on citation count.

Results

This analysis reveals the rapid expansion of AI in SOT. Key areas include robotic surgery, organ allocation, outcome prediction, immunosuppression management, and precision medicine. Robotic surgery has improved transplant outcomes. AI algorithms optimize organ matching and enhance fairness. Machine learning models predict outcomes and guide treatment, while AI-based systems advance personalized immunosuppression. AI in precision medicine, including diagnostics and imaging, is crucial for transplant success.

Conclusion

This study highlights AI’s transformative potential in SOT, with significant contributions from countries like the USA, Canada, and the UK. Key institutions such as the University of Toronto and the University of Pittsburgh have played vital roles. However, practical challenges like ethical issues, bias, and data integration remain. Fostering international and interdisciplinary collaborations is crucial for overcoming these challenges and accelerating AI’s integration into clinical practice, ultimately improving patient outcomes.
{"title":"Knowledge domain and frontier trends of artificial intelligence applied in solid organ transplantation: A visualization analysis","authors":"Miao Gong ,&nbsp;Yingsong Jiang ,&nbsp;Yingshuo Sun ,&nbsp;Rui Liao ,&nbsp;Yanyao Liu ,&nbsp;Zikang Yan ,&nbsp;Aiting He ,&nbsp;Mingming Zhou ,&nbsp;Jie Yang ,&nbsp;Yongzhong Wu ,&nbsp;Zhongjun Wu ,&nbsp;ZuoTian Huang ,&nbsp;Hao Wu ,&nbsp;Liqing Jiang","doi":"10.1016/j.ijmedinf.2024.105782","DOIUrl":"10.1016/j.ijmedinf.2024.105782","url":null,"abstract":"<div><h3>Background</h3><div>Solid organ transplantation (SOT) is vital for end-stage organ failure but faces challenges like organ shortage and rejection. Artificial intelligence (AI) offers potential to improve outcomes through better matching, success prediction, and automation. However, the evolution of AI in SOT research remains underexplored. This study uses bibliometric analysis to identify trends, hotspots, and key contributors in the field.</div></div><div><h3>Methods</h3><div>821 articles from the Web of Science Core Collection were exported for analysis. Microsoft Excel 2021 was used for descriptive statistics. VOSviewer, CiteSpace, Scimago Graphica, and Biblioshiny were used for bibliometric analysis. The ggalluvial package in R was utilized to create Sankey diagrams, and top articles were selected based on citation count.</div></div><div><h3>Results</h3><div>This analysis reveals the rapid expansion of AI in SOT. Key areas include robotic surgery, organ allocation, outcome prediction, immunosuppression management, and precision medicine. Robotic surgery has improved transplant outcomes. AI algorithms optimize organ matching and enhance fairness. Machine learning models predict outcomes and guide treatment, while AI-based systems advance personalized immunosuppression. AI in precision medicine, including diagnostics and imaging, is crucial for transplant success.</div></div><div><h3>Conclusion</h3><div>This study highlights AI’s transformative potential in SOT, with significant contributions from countries like the USA, Canada, and the UK. Key institutions such as the University of Toronto and the University of Pittsburgh have played vital roles. However, practical challenges like ethical issues, bias, and data integration remain. Fostering international and interdisciplinary collaborations is crucial for overcoming these challenges and accelerating AI’s integration into clinical practice, ultimately improving patient outcomes.</div></div>","PeriodicalId":54950,"journal":{"name":"International Journal of Medical Informatics","volume":"195 ","pages":"Article 105782"},"PeriodicalIF":3.7,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Developing an AI-Based clinical decision support system for basal insulin titration in type 2 diabetes in primary Care: A Mixed-Methods evaluation using heuristic Analysis, user Feedback, and eye tracking 开发基于人工智能的2型糖尿病初级保健基础胰岛素滴定临床决策支持系统:使用启发式分析、用户反馈和眼动追踪的混合方法评估。
IF 3.7 2区 医学 Q2 COMPUTER SCIENCE, INFORMATION SYSTEMS Pub Date : 2024-12-31 DOI: 10.1016/j.ijmedinf.2024.105783
Camilla Heisel Nyholm Thomsen , Thomas Kronborg , Stine Hangaard , Peter Vestergaard , Morten Hasselstrøm Jensen

Background and aim

The progressive nature of type 2 diabetes often, in time, necessitates basal insulin therapy to achieve glycemic targets. However, despite standardized titration algorithms, many people remain poorly controlled after initiating insulin therapy, leading to suboptimal glycemic control and complications. Both healthcare professionals and people with type 2 diabetes have expressed the need for novel tools to aid in this process. Traditional titration methods often lack the precision needed to address individual differences in glycemic response. Recent studies have highlighted the potential of AI-driven solutions, which can leverage large datasets to model patient-specific characteristics. Therefore, this study aims to develop a digital platform for an AI-based clinical decision support system to assist healthcare professionals in primary care with personalized and optimal basal insulin titration for people with type 2 diabetes.

Methods

An iterative mixed-method approach was used for system development, incorporating usability engineering principles. Initial requirements were gathered from domain experts and followed by heuristic evaluation and user-based evaluation. Data from these evaluations guided successive iterations of the prototype.

Results

The initial prototype featured a retrospective graph of insulin doses and fasting glucose levels and a dose adjustment simulation environment. Heuristic evaluation identified 92 issues, primarily related to minimalistic and aesthetic design. The second prototype addressed these concerns, but user-based evaluation found 66 additional usability problems, notably with HbA1c presentation and the need for more glucose measures. The final prototype showed high usability, with a median System Usability Scale score of 93.8. Task completion rates were high (task 1: 87.5%, task 2: 75.0%, and task 3: 100%). Eye-tracking data showed minimal distractions.

Conclusions

The AI-based Clinical Decision Support System shows promise in managing basal insulin titration for people with type 2 diabetes, addressing clinical inertia, and providing a user-friendly, efficient tool to improve glycemic control during insulin titration.
背景与目的:2型糖尿病的进行性往往需要基础胰岛素治疗来达到血糖目标。然而,尽管有标准化的滴定算法,许多人在开始胰岛素治疗后仍然控制不佳,导致血糖控制不佳和并发症。医疗保健专业人员和2型糖尿病患者都表示需要新的工具来帮助这一过程。传统的滴定方法往往缺乏解决血糖反应个体差异所需的精确性。最近的研究强调了人工智能驱动的解决方案的潜力,它可以利用大型数据集来模拟患者的特定特征。因此,本研究旨在为基于人工智能的临床决策支持系统开发一个数字平台,以帮助医疗保健专业人员在初级保健中为2型糖尿病患者提供个性化和最佳的基础胰岛素滴定。方法:结合可用性工程原理,采用迭代混合方法进行系统开发。从领域专家那里收集初始需求,然后进行启发式评估和基于用户的评估。来自这些评估的数据指导了原型的连续迭代。结果:最初的原型具有胰岛素剂量和空腹血糖水平的回顾性图表和剂量调整模拟环境。启发式评估确定了92个问题,主要与极简主义和美学设计有关。第二个原型解决了这些问题,但基于用户的评估发现了66个额外的可用性问题,特别是糖化血红蛋白的显示和需要更多的葡萄糖测量。最终的原型显示出很高的可用性,系统可用性量表得分中位数为93.8。任务完成率高(任务1:87.5%,任务2:75.0%,任务3:100%)。眼动追踪数据显示干扰最小。结论:基于人工智能的临床决策支持系统有望管理2型糖尿病患者的基础胰岛素滴定,解决临床惯性,并提供一种用户友好,有效的工具来改善胰岛素滴定过程中的血糖控制。
{"title":"Developing an AI-Based clinical decision support system for basal insulin titration in type 2 diabetes in primary Care: A Mixed-Methods evaluation using heuristic Analysis, user Feedback, and eye tracking","authors":"Camilla Heisel Nyholm Thomsen ,&nbsp;Thomas Kronborg ,&nbsp;Stine Hangaard ,&nbsp;Peter Vestergaard ,&nbsp;Morten Hasselstrøm Jensen","doi":"10.1016/j.ijmedinf.2024.105783","DOIUrl":"10.1016/j.ijmedinf.2024.105783","url":null,"abstract":"<div><h3>Background and aim</h3><div>The progressive nature of type 2 diabetes often, in time, necessitates basal insulin therapy to achieve glycemic targets. However, despite standardized titration algorithms, many people remain poorly controlled after initiating insulin therapy, leading to suboptimal glycemic control and complications. Both healthcare professionals and people with type 2 diabetes have expressed the need for novel tools to aid in this process. Traditional titration methods often lack the precision needed to address individual differences in glycemic response. Recent studies have highlighted the potential of AI-driven solutions, which can leverage large datasets to model patient-specific characteristics. Therefore, this study aims to develop a digital platform for an AI-based clinical decision support system to assist healthcare professionals in primary care with personalized and optimal basal insulin titration for people with type 2 diabetes.</div></div><div><h3>Methods</h3><div>An iterative mixed-method approach was used for system development, incorporating usability engineering principles. Initial requirements were gathered from domain experts and followed by heuristic evaluation and user-based evaluation. Data from these evaluations guided successive iterations of the prototype.</div></div><div><h3>Results</h3><div>The initial prototype featured a retrospective graph of insulin doses and fasting glucose levels and a dose adjustment simulation environment. Heuristic evaluation identified 92 issues, primarily related to minimalistic and aesthetic design. The second prototype addressed these concerns, but user-based evaluation found 66 additional usability problems, notably with HbA1c presentation and the need for more glucose measures. The final prototype showed high usability, with a median System Usability Scale score of 93.8. Task completion rates were high (task 1: 87.5%, task 2: 75.0%, and task 3: 100%). Eye-tracking data showed minimal distractions.</div></div><div><h3>Conclusions</h3><div>The AI-based Clinical Decision Support System shows promise in managing basal insulin titration for people with type 2 diabetes, addressing clinical inertia, and providing a user-friendly, efficient tool to improve glycemic control during insulin titration.</div></div>","PeriodicalId":54950,"journal":{"name":"International Journal of Medical Informatics","volume":"195 ","pages":"Article 105783"},"PeriodicalIF":3.7,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Influencing factors: Unveiling patterns and reasons in telehealth care utilization and adoption/avoidance decisions 影响因素:揭示远程医疗保健利用和采用/避免决策的模式和原因。
IF 3.7 2区 医学 Q2 COMPUTER SCIENCE, INFORMATION SYSTEMS Pub Date : 2024-12-30 DOI: 10.1016/j.ijmedinf.2024.105781
Ning Yang , Xin Yang

Background

The rapid expansion of telehealth, accelerated by the COVID-19 pandemic, has highlighted gaps in understanding demographic and health factors shaping its use. Exploring reasons behind individuals’ choices regarding telehealth can guide strategies to promote adoption among diverse populations.

Methods

Data from 5,119 participants in the 2022 Health Information National Trends Survey were analyzed. Dependent variables included telehealth usage and reasons for choosing or avoiding it. Independent variables included demographics, general health, and mental health. Associations were examined using multiple logistic regression models.

Results

Factors significantly associated with higher odds of telehealth use included education (college graduate: OR = 1.57, 95 % CI [1.19, 2.06]), gender (male: OR = 0.69, 95 % CI [0.55, 0.87]), rural residency (nonmetro: OR = 0.72, 95 % CI [0.53, 0.97]), depression (OR = 2.91, 95 % CI [2.29, 3.71]), age (e.g., 35–49: OR = 1.66, 95 % CI [1.2, 2.29]), and general health status (good: OR = 0.78, 95 % CI [0.61, 1], excellent or very good: OR = 0.74, 95 % CI [0.58, 0.95]). Older individuals preferred telehealth for convenience but inclined to avoid it in favor of in-person visits. Asian and other group were less likely to use telehealth for seeking advice and including others in visits.

Conclusions

Disparities in telehealth utilization were observed across gender, age, education, health status, and urbanization levels. Policymakers should focus on equitable delivery methods, updated regulatory frameworks, and reducing access disparities, especially in underserved communities.
背景:2019冠状病毒病大流行加速了远程医疗的迅速扩张,突显了在了解影响其使用的人口和健康因素方面的差距。探索个人选择远程医疗背后的原因可以指导促进不同人群采用远程医疗的战略。方法:对参与2022年健康信息全国趋势调查的5119名参与者的数据进行分析。因变量包括远程医疗的使用情况以及选择或避免远程医疗的原因。独立变量包括人口统计、一般健康和心理健康。使用多重逻辑回归模型检验相关性。结果:更高的远程医疗使用的几率显著相关的主要因素包括教育(大学毕业生:或= 1.57,95% CI[1.19, 2.06]),性别(男:或= 0.69,95% CI[0.55, 0.87]),农村居住(nonmetro:或= 0.72,95% CI[0.53, 0.97])、抑郁(OR = 2.91, 95% CI[2.29, 3.71])、年龄(例如,35-49:或= 1.66,95% CI[1.2, 2.29]),和一般健康状况(好:= 0.78,95%可信区间(0.61,1),优秀或良好:= 0.74,95%可信区间[0.58,0.95])。老年人更喜欢远程医疗,因为方便,但倾向于避免它,而倾向于亲自就诊。亚洲和其他群体不太可能使用远程医疗寻求建议,也不太可能邀请其他人来就诊。结论:远程医疗利用在性别、年龄、教育程度、健康状况和城市化水平方面存在差异。政策制定者应将重点放在公平的交付方法、更新的监管框架和减少获取差距上,特别是在服务不足的社区。
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引用次数: 0
Towards secure and trusted AI in healthcare: A systematic review of emerging innovations and ethical challenges 在医疗保健中实现安全和可信赖的人工智能:对新兴创新和伦理挑战的系统回顾。
IF 3.7 2区 医学 Q2 COMPUTER SCIENCE, INFORMATION SYSTEMS Pub Date : 2024-12-30 DOI: 10.1016/j.ijmedinf.2024.105780
Muhammad Mohsin Khan , Noman Shah , Nissar Shaikh , Abdulnasser Thabet , Talal alrabayah , Sirajeddin Belkhair

Introduction

Artificial Intelligence is in the phase of health care, with transformative innovations in diagnostics, personalized treatment, and operational efficiency. While having potential, critical challenges are apparent in areas of safety, trust, security, and ethical governance. The development of these challenges is important for promoting the responsible adoption of AI technologies into healthcare systems.

Methods

This systematic review of studies published between 2010 and 2023 addressed the applications of AI in healthcare and their implications for safety, transparency, and ethics. A comprehensive search was performed in PubMed, IEEE Xplore, Scopus, and Google Scholar. Those studies that met the inclusion criteria provided empirical evidence, theoretical insights, or systematic evaluations addressing trust, security, and ethical considerations.

Results

The analysis brought out both the innovative technologies and the continued challenges. Explainable AI (XAI) emerged as one of the significant developments. It made it possible for healthcare professionals to understand AI-driven recommendations, by this means increasing transparency and trust. Still, challenges in adversarial attacks, algorithmic bias, and variable regulatory frameworks remain strong. According to several studies, more than 60 % of healthcare professionals have expressed their hesitation in adopting AI systems due to a lack of transparency and fear of data insecurity. Moreover, the 2024 WotNot data breach uncovered weaknesses in AI technologies and highlighted the dire requirement for robust cybersecurity.

Discussion

Full understanding of the potential of AI will be possible only with putting into practice of ethical and technical maintains in healthcare systems. Effective strategies would include integrating bias mitigation methods, strengthening cybersecurity protocols to prevent breaches. Also by adopting interdisciplinary collaboration with the goal of forming transparent regulatory guidelines. These are very important steps toward earning trust and ensuring that AI systems are safe, reliable, and fair.

Conclusion

AI can bring transformative opportunities to improve healthcare outcomes, but successful implementation will depend on overcoming the challenges of trust, security, and ethics. Future research should focus on testing these technologies in multiple real-world settings, enhance their scalability, and fine-tune regulations to facilitate accountability. Only by combining technological innovations with ethical principles and strong governance can AI reshape healthcare, ensuring at the same time safety and trustworthiness.
导读:人工智能正处于医疗保健阶段,在诊断、个性化治疗和运营效率方面具有变革性创新。虽然有潜力,但在安全、信任、安保和道德治理领域面临着明显的关键挑战。这些挑战的发展对于促进在卫生保健系统中负责任地采用人工智能技术非常重要。方法:本系统综述了2010年至2023年间发表的研究,探讨了人工智能在医疗保健中的应用及其对安全性、透明度和伦理的影响。在PubMed, IEEE explore, Scopus和b谷歌Scholar中进行了全面的搜索。那些符合纳入标准的研究提供了经验证据、理论见解或对信任、安全和伦理考虑的系统评估。结果:分析提出了创新技术,同时也提出了持续的挑战。可解释人工智能(XAI)是一个重要的发展。它使医疗保健专业人员能够理解人工智能驱动的建议,从而提高透明度和信任度。尽管如此,对抗性攻击、算法偏见和可变监管框架方面的挑战仍然很强。根据几项研究,超过60%的医疗保健专业人员表示,由于缺乏透明度和担心数据不安全,他们对采用人工智能系统持犹豫态度。此外,2024年WotNot的数据泄露暴露了人工智能技术的弱点,凸显了对强大网络安全的迫切需求。讨论:只有在医疗系统中实施道德和技术维护,才能充分理解人工智能的潜力。有效的策略包括整合偏见缓解方法,加强网络安全协议以防止违规行为。此外,通过采用跨学科合作,目标是形成透明的监管指导方针。这些都是赢得信任和确保人工智能系统安全、可靠和公平的非常重要的步骤。结论:人工智能可以带来变革性的机会,以改善医疗保健结果,但成功实施将取决于克服信任、安全和道德方面的挑战。未来的研究应侧重于在多种现实环境中测试这些技术,增强其可扩展性,并微调法规以促进问责制。只有将技术创新与道德原则和强有力的治理相结合,人工智能才能重塑医疗保健,同时确保安全性和可信度。
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引用次数: 0
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International Journal of Medical Informatics
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