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COVID-19 in the era of artificial intelligence: a black swan event? 人工智能时代的新冠肺炎:黑天鹅事件?
Pub Date : 2021-01-01 DOI: 10.21037/jmai-21-23
Fahad S Mohammed, Hisham Qadri, S. Mohammed
of COVID-19 (3). The large amount of social computational data generated by the pandemic may lead to breakthroughs in AI that can greatly alter human behavior. Newer COVID-19 variants and behavioral changes are causing resurgence of the pandemic. AI can use social computational data to devise novel non-pharmaceutical interventions to prevent newer outbreaks. “How we feel” a web and mobile application that longitudinally tracks COVID-19 symptoms, behavior and testing, can predict likely COVID-19 positive individuals and outbreaks (4). Genomic, structural data and outcomes can be used to make COVID-19 simulations, predict mutations, outbreaks and guide therapy leading to drug discovery, drug repurposing and precision medicine (5). Multiple applications for predicting severity using imaging and lab data in real time have been developed and have been externally validated (6). These applications have played a pivotal role in the management of the pandemic.
(3)大流行产生的大量社会计算数据可能会导致人工智能的突破,从而极大地改变人类的行为。新的COVID-19变体和行为变化正在导致大流行死灰复燃。人工智能可以利用社会计算数据设计新的非药物干预措施,以防止新的疫情爆发。“我们的感受”是一个网络和移动应用程序,可以纵向跟踪COVID-19的症状、行为和测试,可以预测可能的COVID-19阳性个体和疫情(4)。基因组、结构数据和结果可用于模拟COVID-19,预测突变、疫情和指导治疗,从而发现药物。药物再利用和精准医疗(5)。利用成像和实验室数据实时预测严重程度的多种应用已经开发出来,并已得到外部验证(6)。这些应用在大流行的管理中发挥了关键作用。
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引用次数: 0
Intersection of artificial intelligence and medicine: tort liability in the technological age 人工智能与医学的交叉:技术时代的侵权责任
Pub Date : 2020-12-01 DOI: 10.21037/jmai-20-57
Kyle T. Jorstad
: This note presents an analysis of the medico-legal and bioethical risks posed by the incorporation of artificial intelligence (AI) and machine learning into clinical radiology practice, with specific focus on the field of mammography. The analysis presents an overview of the current medical malpractice framework relative to mammography; examines the fitness of current legal frameworks for apportioning liability in cases of injury resulting from errors by machine learning tools; evaluates various options for addressing the malpractice model’s gaps as AI is incorporated into clinical patient care; and provides means by which the healthcare industry may both minimize short-term liability for machine learning error, while ensuring that neither the public nor the regulatory framework are unnecessarily biased against the use of AI in medicine.
:本说明分析了将人工智能(AI)和机器学习纳入临床放射学实践所带来的医疗法律和生物伦理风险,特别关注乳房X光检查领域。该分析概述了当前与乳房X光检查相关的医疗事故框架;审查当前法律框架是否适合在机器学习工具错误造成伤害的情况下分摊责任;随着人工智能被纳入临床患者护理,评估解决医疗事故模型缺口的各种选择;并提供了医疗保健行业既可以最大限度地减少机器学习错误的短期责任,同时确保公众和监管框架都不会对人工智能在医学中的使用产生不必要的偏见。
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引用次数: 5
Interpretative applications of artificial intelligence in musculoskeletal imaging: concepts, current practice, and future directions 人工智能在肌肉骨骼成像中的解释性应用:概念、当前实践和未来方向
Pub Date : 2020-08-17 DOI: 10.21037/jmai-20-30
Teresa T. Martin-Carreras, Hongming Li, Po-Hao Chen
: Artificial intelligence (AI) promises wide-reaching impacts on the field of radiology, and has the potential to influence every aspect of image interpretation. In recent decades, significant advancements in computing power, combined with the availability of large data stores or “Big Data” and algorithm democratization have revolutionized AI and machine learning (ML). Research applications utilizing these technological advancements are booming, and their adoption is expected to continue to rise at a rapid pace. While AI and ML have impacted many components of the imaging value chain, the purpose of this article is to discuss interpretative uses of the technology as it relates to musculoskeletal (MSK) radiology. This review provides a general introduction to AI and ML concepts, and highlights the major promises, challenges, and anticipated future applications of these developments in MSK radiology. AI and ML advances for image interpretation can increase the value that MSK radiologists provide to their patients, referring clinicians, and organizations by increasing diagnostic accuracy while decreasing turnaround times, enhancing image processing and quantitative analysis, and by potentially improving patient outcomes. Familiarity with these processes among MSK clinicians and researchers will be paramount to the improvement and implementation of these new techniques into the clinical practice. Radiology departments, practices and practitioners who embrace these technologies now will be well-suited to lead this influential change in our field in the near future.
:人工智能有望对放射学领域产生广泛影响,并有可能影响图像解释的各个方面。近几十年来,计算能力的重大进步,加上大型数据存储或“大数据”的可用性和算法民主化,彻底改变了人工智能和机器学习(ML)。利用这些技术进步的研究应用正在蓬勃发展,预计其采用率将继续快速上升。虽然人工智能和ML影响了成像价值链的许多组成部分,但本文的目的是讨论该技术在肌肉骨骼(MSK)放射学方面的解释性使用。这篇综述对人工智能和ML概念进行了全面介绍,并强调了这些发展在MSK放射学中的主要前景、挑战和预期的未来应用。AI和ML在图像解释方面的进步可以提高MSK放射科医生为患者、转诊临床医生和组织提供的价值,方法是提高诊断准确性,同时减少周转时间,增强图像处理和定量分析,并可能改善患者的预后。MSK临床医生和研究人员对这些过程的熟悉对于这些新技术在临床实践中的改进和实施至关重要。现在接受这些技术的放射科、诊所和从业者将非常适合在不久的将来领导我们领域的这一有影响力的变革。
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引用次数: 3
Impact of machine learning and feature selection on type 2 diabetes risk prediction 机器学习和特征选择对2型糖尿病风险预测的影响
Pub Date : 2020-06-01 DOI: 10.21037/jmai-20-4
Päivi Riihimaa
This survey summarizes the state of the art for type 2 diabetes mellitus (T2DM) prediction and compares the prediction accuracies obtained by conventional statistical regression and machine learning methods, including deep learning. The impact of feature selection and inclusion of clinical and genomic data on T2DM risk prediction accuracy is also reviewed. The results show that there is a tendency that machine learning algorithms outperform logistic regression in the accuracy of T2DM prediction. Inclusion of clinical data and biomarkers to the core feature set improves accuracy, while incorporating genetic markers in the prediction model is still challenging, due to dimensionality problem and the genetic heterogeneity of T2DM.
本研究总结了2型糖尿病(T2DM)预测的最新进展,并比较了传统统计回归和机器学习方法(包括深度学习)的预测精度。本文还回顾了特征选择和纳入临床和基因组数据对T2DM风险预测准确性的影响。结果表明,机器学习算法在预测T2DM的准确性方面有优于逻辑回归的趋势。将临床数据和生物标记物纳入核心特征集可以提高准确性,但由于维度问题和2型糖尿病的遗传异质性,将遗传标记物纳入预测模型仍然具有挑战性。
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引用次数: 4
Improving ultrasound video classification: an evaluation of novel deep learning methods in echocardiography. 改进超声视频分类:超声心动图中新型深度学习方法的评价。
Pub Date : 2020-03-25 DOI: 10.21037/jmai.2019.10.03
James P Howard, Jeremy Tan, Matthew J Shun-Shin, Dina Mahdi, Alexandra N Nowbar, Ahran D Arnold, Yousif Ahmad, Peter McCartney, Massoud Zolgharni, Nick W F Linton, Nilesh Sutaria, Bushra Rana, Jamil Mayet, Daniel Rueckert, Graham D Cole, Darrel P Francis

Echocardiography is the commonest medical ultrasound examination, but automated interpretation is challenging and hinges on correct recognition of the 'view' (imaging plane and orientation). Current state-of-the-art methods for identifying the view computationally involve 2-dimensional convolutional neural networks (CNNs), but these merely classify individual frames of a video in isolation, and ignore information describing the movement of structures throughout the cardiac cycle. Here we explore the efficacy of novel CNN architectures, including time-distributed networks and two-stream networks, which are inspired by advances in human action recognition. We demonstrate that these new architectures more than halve the error rate of traditional CNNs from 8.1% to 3.9%. These advances in accuracy may be due to these networks' ability to track the movement of specific structures such as heart valves throughout the cardiac cycle. Finally, we show the accuracies of these new state-of-the-art networks are approaching expert agreement (3.6% discordance), with a similar pattern of discordance between views.

超声心动图是最常见的医学超声检查,但自动解释具有挑战性,并且取决于对“视图”(成像平面和方向)的正确识别。目前最先进的计算识别视图的方法包括二维卷积神经网络(cnn),但这些方法仅仅对视频的单个帧进行隔离分类,而忽略了整个心脏周期中描述结构运动的信息。在这里,我们探讨了新型CNN架构的有效性,包括时间分布网络和双流网络,它们受到人类动作识别技术进步的启发。我们证明,这些新架构将传统cnn的错误率从8.1%降低到3.9%,减少了一半以上。这些准确性的进步可能是由于这些网络在整个心脏周期中跟踪特定结构(如心脏瓣膜)运动的能力。最后,我们表明这些新的最先进的网络的准确性正在接近专家协议(3.6%不一致),观点之间的不一致模式类似。
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引用次数: 28
A systematic literature review of predicting diabetic retinopathy, nephropathy and neuropathy in patients with type 1 diabetes using machine learning 使用机器学习预测1型糖尿病患者的糖尿病视网膜病变、肾病和神经病变的系统文献综述
Pub Date : 2020-03-01 DOI: 10.21037/jmai.2019.10.04
Qingqing Xu, Li-ye Wang, S. Sansgiry
Background: Diabetic retinopathy, nephropathy and neuropathy in patients with type 1 diabetes (T1D) are microvascular complications that can adversely impact disease prognosis and incur greater healthcare costs. Early identification of patients at risk of these microvascular complications using predictive models through machine learning (ML) can be helpful in T1D management. The objective of current review was to systematically identify and summarize published predictive models that used ML to assess the risk of diabetic nephropathy, retinopathy and neuropathy in T1D patients. Methods: A targeted review of English literature was undertaken in PubMed (http://www.ncbi.nlm.nih. gov/pubmed) and Google Scholar (http://scholar.google.com/) from January 1, 2016 to May 31, 2019. Eligible articles were also identified from cross-references. Following concepts were used in combination to conduct the search queries: diabetes, retinopathy, nephropathy, neuropathy, microvascular complication, risk/predictive model, and ML/artificial intelligence/data mining. Results: A total of 3,769 hits were found from all sources combined, duplicates were removed, titles and abstracts were screened, 61 studies underwent full-text review and a total of six studies met the eligibility criteria. Among them, four studies had developed risk models using data obtained from T1D patients alone, whereas two used data from both T1D and type 2 diabetes (T2D) patients. There was only one study that evaluated all three types of microvascular complications while the other five focused on one individual complication, i.e., either diabetic retinopathy, nephropathy or neuropathy. Only two studies evaluated time to developing a complication. The other four studies assessed complications as either binary (yes/no) or categorical (multiple levels). Prediction models were built using cross-sectional data from survey questionnaire (n=1, Iran) and longitudinal data (n=5) which were further classified as sources of electronic medical records (EMR) (n=3, US: 1, Europe: 2), clinical trial (n=1, US) and prospective study (n=1, Europe). Common predictors across studies as well as across types of microvascular complications included age, gender, diabetes duration, BMI, blood pressure, lipid level, and mean or a single HbA1C value. Commonly used ML algorithms included classification and regression tree (CART) and random forest (RF) (CART/RF, n=3), support vector machines (SVMs, n=2), logistic regression (LR, n=2) and neural networks (NNs, n=1). Model performance was evaluated using area under curve (AUC, n=4) and accuracy (n=2). Only half (n=3) of the included studies tested their developed models in an external dataset of patients with T1D. Conclusions: Overall, very few studies reported predictive models for diabetic retinopathy, nephropathy and neuropathy using ML specifically for T1D patients. Future research that utilizes contemporary clinical data from T1D patients to predict the three types o
背景:1型糖尿病(T1D)患者的糖尿病视网膜病变、肾病和神经病变是微血管并发症,可对疾病预后产生不利影响,并导致更高的医疗费用。通过机器学习(ML)使用预测模型早期识别有这些微血管并发症风险的患者可能有助于T1D的管理。本综述的目的是系统地识别和总结已发表的使用ML评估T1D患者糖尿病肾病、视网膜病变和神经病变风险的预测模型。方法:对PubMed (http://www.ncbi.nlm.nih)上的英文文献进行有针对性的综述。gov/pubmed)和谷歌Scholar (http://scholar.google.com/),时间为2016年1月1日至2019年5月31日。还从交叉参考中确定了符合条件的文章。结合以下概念进行搜索查询:糖尿病、视网膜病变、肾病、神经病变、微血管并发症、风险/预测模型、ML/人工智能/数据挖掘。结果:从所有来源中总共找到了3769个点击率,删除了重复,筛选了标题和摘要,对61项研究进行了全文审查,共有6项研究符合资格标准。其中,4项研究仅使用T1D患者的数据建立了风险模型,2项研究同时使用了T1D和2型糖尿病(T2D)患者的数据。只有一项研究评估了所有三种类型的微血管并发症,而其他五项研究关注的是一种并发症,即糖尿病视网膜病变、肾病或神经病变。只有两项研究评估了发生并发症的时间。其他四项研究评估并发症为二元(是/否)或分类(多级)。利用调查问卷(n=1,伊朗)和纵向数据(n=5)的横断面数据建立预测模型,并进一步分类为电子病历(EMR)来源(n=3,美国:1,欧洲:2)、临床试验(n=1,美国)和前瞻性研究(n=1,欧洲)。研究中常见的预测因素以及微血管并发症类型包括年龄、性别、糖尿病病程、BMI、血压、血脂水平和平均或单一HbA1C值。常用的机器学习算法包括分类回归树(CART)和随机森林(RF) (CART/RF, n=3)、支持向量机(svm, n=2)、逻辑回归(LR, n=2)和神经网络(NNs, n=1)。使用曲线下面积(AUC, n=4)和精度(n=2)评估模型性能。在纳入的研究中,只有一半(n=3)的研究在T1D患者的外部数据集中测试了他们开发的模型。结论:总体而言,很少有研究报道了专门针对T1D患者的ML用于糖尿病视网膜病变、肾病和神经病变的预测模型。未来的研究需要利用T1D患者的当代临床数据来预测三种类型的微血管并发症。
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引用次数: 9
Machine learning can accelerate discovery and application of cyber-molecular cancer diagnostics. 机器学习可以加速网络分子癌症诊断的发现和应用。
Pub Date : 2020-03-01 DOI: 10.21037/jmai.2020.01.01
David S Campo, Yury Khudyakov
© Journal of Medical Artificial Intelligence. All rights reserved. J Med Artif Intell 2020;3:7 | http://dx.doi.org/10.21037/jmai.2020.01.01 Accurate and early cancer diagnosis is fundamental for clinical management and public health. Unfortunately, the biological complexity of cancer confounds the development of effective diagnostic approaches to its detection. Histological examination of tissue samples obtained by biopsy directly from solid tumors and imaging technologies remain as the mainstays of cancer diagnostics. The liquid biopsy concept aims to overcome the shortcomings of these onco-diagnostics by detecting tumor-derived biomarkers such as circulating tumor cells, extracellular vesicles, nucleosomes, proteins, antigens, and extracellular nucleic acids in blood (1). Among many, mitochondrial DNA (mtDNA) is one of the most promising biomarkers of liquid biopsy. Mitochondria are highly abundant in human body, exceeding the number of human cells by 100–10,000 times. They play an essential role in the whole-body physiology, being involved in bioenergetics, apoptosis, innate immunity, networks of communication with different cell types and metabolic coordination. Owing to such fundamental involvement of mitochondria in human physiology, mtDNA mutations in general have a highly detrimental effect on cell viability. Nevertheless, the astronomical mitochondrial population size, lack of genetic mechanisms for effective control of mutations, genetic complementation and vegetative segregation of mtDNA establish an environment that supports a significant intra-host mitochondrial genetic heterogeneity, known as heteroplasmy (2). Some health conditions, such as cancer are potentially conducive to maintaining heteroplasmy. The intra-host mitochondrial genetic diversity detected in blood is very dynamic and may change at the rate usually observed in intra-host viral populations, rapidly responding to, for example, progression of cancer or hepatitis C virus infection (3-5). The dynamic nature of mitochondrial genetic heterogeneity in blood offers potential diagnostic opportunities for the detection of cancer and other health conditions (3,6). The fluid biopsy concept takes advantage of such opportunities and provides guiding principles for diagnosing and managing cancer using blood rather than solid tumor tissue, with several molecular approaches being developed for the direct detection of circulating mtDNA variants associated with cancer (7,8). We recently showed that heterogeneity at specially selected polymorphic mtDNA sites can be efficiently associated with liver cancer by means of machine learning, suggesting a different research direction towards development of novel cyber-molecular diagnostics (6). Such assays are basically complex computational models capable of extracting diagnostically relevant information from molecular data obtained using Ultra-Deep Sequencing (UDS) technologies. Molecular wet-laboratory assays generate diagnostic information
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引用次数: 2
The future of anatomic pathology: deus ex machina? 解剖病理学的未来:机械救主?
Pub Date : 2019-12-03 DOI: 10.21037/JMAI.2019.02.03
R. Dietz, L. Pantanowitz
This editorial is in response to the article on digital pathology published by Van Es (1), which is in turn a response to the articles published by Eric F. Glassy (2) and Thomas James Flotte (3). Our goal is to add what we feel are pertinent historical details and offer our perspective concerning the emerging role of digital pathology in anatomic pathology.
这篇社论是对Van Es(1)发表的关于数字病理学的文章的回应,这篇文章反过来是对Eric F. Glassy(2)和Thomas James Flotte(3)发表的文章的回应。我们的目标是添加我们认为相关的历史细节,并提供我们对数字病理学在解剖病理学中的新兴作用的看法。
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引用次数: 4
Application of the CARE guideline as reporting standard in the Journal of Medical Artificial Intelligence CARE指南作为报告标准在《医学人工智能杂志》上的应用
Pub Date : 2019-12-01 DOI: 10.21037/jmai.2019.10.02
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引用次数: 0
The prospect of artificial intelligence in the differential diagnosis of pancreatic cysts 人工智能在胰腺囊肿鉴别诊断中的应用前景
Pub Date : 2019-10-12 DOI: 10.21037/jmai.2019.09.05
M. Montorsi, G. Capretti
The title of the work we are here presenting “ Diagnostic ability of artificial intelligence using deep learning analysis of cyst fluid in differentiating malignant from benign pancreatic cystic lesions ” immediately strikes the interest of readers, especially of the ones performing pancreatic surgery (1). This article debates a theme of major concern for surgeons, the correct identification of a pancreatic cystic lesion, and a theme of major concern for the medical society and the society in general, the application of artificial intelligence (AI).
我们在这里介绍的这项工作的标题“使用囊肿液的深度学习分析来区分胰腺囊性病变的人工智能诊断能力”立即引起了读者的兴趣,尤其是那些进行胰腺手术的读者(1)。本文讨论了外科医生最关心的一个主题,胰腺囊性病变的正确识别,以及医学会和整个社会最关心的主题,人工智能(AI)的应用。
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引用次数: 0
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Journal of medical artificial intelligence
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