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Automotive Health 2.0: Steering Toward Proactive Preventive Care 汽车健康2.0:转向主动预防护理
Pub Date : 2025-12-26 DOI: 10.1016/j.mcpdig.2025.100334
Dominik Naumann MD , Tatjana Amler MSc , Doreen Schoeppenthau MD , Sergej Holzmann MSc , Jörg Preißinger PhD , Matthias Franz PhD , Heyo K. Kroemer PhD , Alexander Meyer MD
Cardiovascular and chronic disease prevention remains limited by episodic, clinic-based assessments that fail to capture physiological changes arising in daily life. As mobility constitutes one of the most stable and repetitive environments people inhabit, vehicles offer a unique setting for subliminal, continuous health monitoring. This narrative presents the rationale and foundational framework for Automotive Health 2.0, a clinically oriented paradigm that transforms connected vehicles into validated platforms for physiological sensing, data integration, and proactive care delivery. Building on existing in-cabin cameras, radar, and microphones, multimodal algorithms enable unobtrusive estimation of cardiovascular, respiratory, and behavioral parameters during routine driving. Technological innovation lies in combining these signals with artificial intelligence-driven analytics to detect early disease signatures, support dynamic risk assessment, and enable adaptive telemonitoring directly linked to electronic health records. Clinically, this approach distinguishes regulatory-grade monitoring from consumer wellness tools by prioritizing accuracy, reproducibility, and integration with established workflows. Patients gain earlier detection and more equitable access to preventive care; clinicians receive continuous actionable data, and health systems benefit from scalable population-level monitoring. Automotive Health 2.0 positions the vehicle as a novel extension of the health care ecosystem, embedding validated prevention seamlessly into everyday life.
心血管和慢性疾病的预防仍然受到偶发的、基于临床的评估的限制,这些评估未能捕捉到日常生活中产生的生理变化。由于移动性构成了人们居住的最稳定和重复的环境之一,车辆为潜意识的持续健康监测提供了独特的环境。本文介绍了汽车健康2.0的基本原理和基本框架,这是一种以临床为导向的范式,将互联汽车转变为生理传感、数据集成和主动护理交付的验证平台。基于现有的车内摄像头、雷达和麦克风,多模态算法可以在日常驾驶过程中对心血管、呼吸和行为参数进行不显眼的估计。技术创新在于将这些信号与人工智能驱动的分析相结合,以检测早期疾病特征,支持动态风险评估,并实现与电子健康记录直接相关的自适应远程监测。临床上,这种方法通过优先考虑准确性、可重复性和与既定工作流程的集成,将监管级监测与消费者健康工具区分开来。患者可以更早发现并更公平地获得预防保健;临床医生获得持续的可操作数据,卫生系统受益于可扩展的人群水平监测。汽车健康2.0将车辆定位为医疗保健生态系统的新延伸,将有效的预防无缝嵌入日常生活中。
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引用次数: 0
Increased Utilization of Telemedical Emergency and Nonurgent Care Following Deployment of Virtual Triage and Care Referral in Australia 在澳大利亚部署虚拟分诊和护理转诊后,远程医疗急诊和非紧急护理的利用率增加
Pub Date : 2025-12-19 DOI: 10.1016/j.mcpdig.2025.100331
George A. Gellert MD, MPH, MPA , Bettina McMahon MBA , Tim Price MS , Zhixin Liu PhD , Aleksandra Kabat-Karabon MS , Maria Marecka MD , Mitchell Burger MPH , Lijing Ma PhD , Nirvana Luckraj MD

Objective

To evaluate whether an artificial intelligence–based national virtual triage and care referral (VTCR) service in Australia improved care acuity level alignment, increased patient engagement of telemedicine services, and reduced emergency department demand by offering lower acuity, less costly options for urgent, virtual, or in-person care services.

Patients and Methods

Cross-sectional analyses examined changes in patient care intent following VTCR to determine whether it facilitated patient adoption of new emergency and nonurgent telemedicine and virtual care services.

Results

Virtual triage and care referral more than doubled the number of patients selecting appropriate, lower acuity nonurgent care from 330,279 (21.3%) to 820,800 (52.9%), an increase of 31.6 percentage points [PPs] (P<.01), and effectively eliminated uncertainty in patient care seeking from 670,502 to 2557 patients, a decrease of 99.6%. Intent for in-person emergency care fell significantly from 119,414 (36.7%) to 105,349 patients (24.6%) (–12.1 PP; P<.01), replaced by substantial growth in patient intent to use virtual emergency care (from 612 to 11,840 patients or +10.1 PP) and nonurgent virtual care use (from 20,467 to 26,289 patients or +2.9 PP) (P<.01). Victoria, a state within Australia, recorded the highest uptake. Extrapolated nationally, these shifts could prevent an estimated 2409 unnecessary in-person nonurgent visits and 19,286 unnecessary emergency department visits annually in Australia. Aboriginal and Indigenous patients showed similar benefits and engaged VTCR at higher rates than other patients.

Conclusion

Artificial intelligence–based VTCR improved alignment between patient perceived needs and recommended care pathways, not only driving greater use of appropriate, lower acuity, and telemedicine services but also reducing unnecessary in-person emergency visits. By eliminating uncertainty in care seeking and advancing adoption of new virtual emergency and nonurgent care options, VTCR offers a scalable, evidence-based solution for optimizing emergent and urgent care delivery and easing pressure on emergency departments across Australia.
目的评估澳大利亚基于人工智能的国家虚拟分诊和护理转诊(VTCR)服务是否通过提供更低的视敏度、更低成本的紧急、虚拟或面对面护理服务,改善了护理敏锐度水平的一致性,提高了患者对远程医疗服务的参与度,并减少了急诊科的需求。患者和方法横断面分析检查了VTCR后患者护理意图的变化,以确定它是否促进了患者采用新的紧急和非紧急远程医疗和虚拟护理服务。结果虚拟分诊与转诊使选择合适、低视敏度非急诊的患者从330279例(21.3%)增加到820800例(52.9%),增加了31.6个百分点[PPs] (P< 0.01),有效消除了患者求诊的不确定性,从670502例增加到2557例,减少了99.6%。面对面急诊的意向从119,414例(36.7%)显著下降到105,349例(24.6%)(-12.1 PP; P< 0.01),取而代之的是使用虚拟急诊的患者意向的大幅增长(从612例到11,840例或+10.1 PP)和非紧急虚拟护理的使用(从20,467例到26,289例或+2.9 PP) (P< 0.01)。澳大利亚的维多利亚州的入学率最高。在全国范围内推断,这些转变每年可以防止2409次不必要的非紧急亲自就诊和19286次不必要的急诊就诊。土著和土著患者表现出类似的益处,并且参与VTCR的比例高于其他患者。基于人工智能的VTCR改善了患者感知需求和推荐护理路径之间的一致性,不仅推动了更多地使用适当的、低敏锐度的远程医疗服务,还减少了不必要的亲自急诊就诊。通过消除求诊过程中的不确定性,推进采用新的虚拟急诊和非急诊护理方案,VTCR为优化急诊和急诊护理提供了可扩展的、基于证据的解决方案,减轻了澳大利亚急诊部门的压力。
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引用次数: 0
Granular Machine Learning-Based Computed Tomography Contrast Phase Prediction 基于颗粒机器学习的计算机断层扫描对比相位预测
Pub Date : 2025-12-19 DOI: 10.1016/j.mcpdig.2025.100332
S. Moein Rassoulinejad-Mousavi PhD , Bardia Khosravi MD, MPH, MHPE , Alex D. Weston PhD , Ryan T. Moerer BSc , Aaron E. Carretero Benites BSc , Hillary W. Garner MD , Naoki Takahashi MD , Timothy L. Kline PhD , Michael F. Romero PhD , John C. Lieske MD , Bradley J. Erickson MD, PhD

Objective

To develop and evaluate a machine learning framework that detects intravenous contrast and distinguishes eight granular renal contrast phases on abdominal computed tomography (CT) scans to improve renal assessment.

Patients and Methods

This retrospective study included abdominal CT scans obtained at Mayo Clinic from January 1, 2001, to December 31, 2009. In total, 3033 scans from 1017 patients with renal cell carcinoma were included. A ConvNeXt-Femto deep learning (DL) model with dual output heads was trained for contrast detection and renal contrast phase prediction using binary classification and regression objectives, respectively. A random forest (RF) regression model was trained on DL-extracted features to predict 8 fine-grained phases spanning early to late corticomedullary, nephrographic, and pyelographic. Model performance was further evaluated using an internal-external cohort of abdominal CT scans from January 1, 2010, to December 31, 2020, comprising of 8856 series from 4760 patients.

Results

The DL classifier detected contrast presence with 100% accuracy. The DL-only regression model reached a mean absolute error of 0.34, compared with 0.29 for the hybrid DL+RF model. Agreement analysis between the models’ ensemble and 2 radiologists reported reliability, with κ values of 0.86 for predicting the exact category, 1.00 for neighboring categories, and 0.98 for super-category grouping. Internal-external validation indicated that the model successfully operated across datasets differing in patient cohort and imaging characteristics.

Conclusion

This DL+RF framework enables automated granular renal contrast phase discrimination and reduces inter-rater variability, representing a meaningful advancement in artificial intelligence-assisted abdominal CT interpretation and supporting improved patient care.
目的开发和评估一种机器学习框架,用于检测静脉造影剂并区分腹部计算机断层扫描(CT)上的八个颗粒肾造影剂阶段,以改善肾脏评估。患者和方法本回顾性研究包括2001年1月1日至2009年12月31日在梅奥诊所获得的腹部CT扫描。总共包括1017例肾细胞癌患者的3033次扫描。采用二元分类和回归目标分别训练了具有双输出头的ConvNeXt-Femto深度学习(DL)模型,用于对比检测和肾脏对比期预测。随机森林(RF)回归模型在dl提取的特征上进行训练,以预测8个细粒度阶段,包括早期到晚期的皮质髓质、肾盂和肾盂。通过2010年1月1日至2020年12月31日的腹部CT扫描的内外队列,包括来自4760名患者的8856个系列,进一步评估了模型的性能。结果DL分类器检测造影剂的准确率为100%。DL-only回归模型的平均绝对误差为0.34,而DL+RF混合模型的平均绝对误差为0.29。模型集合与2名放射科医生之间的一致性分析报告了可靠性,预测确切类别的κ值为0.86,邻近类别的κ值为1.00,超类别分组的κ值为0.98。内部和外部验证表明,该模型成功地在不同患者队列和成像特征的数据集上运行。结论:该DL+RF框架可实现自动颗粒肾对比期鉴别,减少了分级间的差异,代表了人工智能辅助腹部CT判读的有意义的进步,并支持改善患者护理。
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引用次数: 0
Artificial Intelligence Research as a Continuous Clinical Service 作为持续临床服务的人工智能研究
Pub Date : 2025-12-17 DOI: 10.1016/j.mcpdig.2025.100330
Yixi Xu PhD, Rahul Dodhia PhD, Juan M. Lavista Ferres PhD, MS, William B. Weeks MD, PhD, MBA
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引用次数: 0
Acceptability of Using Artificial Intelligence in the National Health Service Breast Screening Program: A Randomized Online Survey of Screening-Eligible Women in England 在国家健康服务乳房筛查项目中使用人工智能的可接受性:一项针对英格兰符合筛查条件的妇女的随机在线调查
Pub Date : 2025-12-17 DOI: 10.1016/j.mcpdig.2025.100329
Lauren Gatting PhD , Charlotte Kelley Jones PhD , Babak Jamshidi PhD , Angie A. Kehagia PhD , Jo Waller PhD

Objective

To compare acceptability of 2 artificial intelligence (AI) use cases in the English National Health Servic Breast Screening Program.

Patients and Methods

From February 7 to March 14 2024, we conducted an online survey, randomizing participants to information about using AI either as the second mammogram reader or to triage mammograms. In the triage scenario, only higher-risk images would be reviewed by a human reader. The survey was completed by 3419 women aged 45 to 70 years, recruited from an online panel. The primary outcome was acceptability of the presented AI use case. We assessed a range of psychological and demographic factors. Regression modeling examined predictors of acceptability.

Results

Using AI as a second reader was rated as more acceptable (P<.001), less concerning (P<.001), and less likely to put people off screening (P=.001) than using it as a triage tool. In both groups, most women said AI would not affect their breast screening attendance (1251/1710 [73%] and 1195/1709 [70%] in the second reader and triage groups, respectively). Nevertheless, 15% (498/3419) of participants stated that the use of AI would make them less likely to attend. After adjusting for AI use case, acceptability was higher in respondents of older age, White ethnicity, higher education, greater AI knowledge, and with more positive attitudes toward both AI and breast screening.

Conclusion

Artificial intelligence in breast screening was rated as more acceptable if used alongside, rather than instead of, a human reader. Ongoing careful evaluation is needed to ensure its roll-out does not widen existing social inequalities and that the risk-benefit profile of screening is maintained.
目的比较英国国民健康服务乳腺筛查项目中2个人工智能(AI)用例的可接受性。患者和方法从2024年2月7日到3月14日,我们进行了一项在线调查,随机分配参与者使用人工智能作为第二乳房x光检查阅读器或分类乳房x光检查的信息。在分类场景中,只有高风险的图像才会被人类读者审查。该调查是由3419名年龄在45岁至70岁之间的女性完成的,她们是从一个在线小组中招募的。主要结果是所呈现的AI用例的可接受性。我们评估了一系列心理和人口因素。回归模型检验了可接受性的预测因子。结果使用人工智能作为第二阅读者被评为更可接受(P<.001),更少关注(P<.001),并且不太可能使人们放弃筛查(P=.001)。在两组中,大多数女性表示人工智能不会影响她们的乳房筛查出勤率(在第二阅读者组和分诊组中分别为1251/1710[73%]和1195/1709[70%])。然而,15%(498/3419)的参与者表示,使用人工智能会使他们不太可能参加。在对人工智能用例进行调整后,年龄较大、白人、受过高等教育、对人工智能有更多了解、对人工智能和乳房筛查都持更积极态度的受访者的可接受性更高。结论人工智能在乳房筛查中与人类读者一起使用比代替人类读者使用更容易被接受。需要进行持续的仔细评估,以确保其推出不会扩大现有的社会不平等,并保持筛查的风险-收益概况。
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引用次数: 0
Uncontrolled Semantic Adaptation in Clinical Evaluation of Large Language Models 大型语言模型临床评价中的不受控语义适应
Pub Date : 2025-12-06 DOI: 10.1016/j.mcpdig.2025.100309
Alfredo Di Giovanni MD
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引用次数: 0
Clinical Reformation in the Age of Artificial Intelligence: Safeguarding the Ethical Centre of Medicine 人工智能时代的临床改革:维护医学伦理中心
Pub Date : 2025-12-05 DOI: 10.1016/j.mcpdig.2025.100310
Ian Io Lei MD , Wojciech Marlicz MD, PhD , Ramesh P. Arasaradnam MD, PhD , Anastasios Koulaouzidis MD, PhD
{"title":"Clinical Reformation in the Age of Artificial Intelligence: Safeguarding the Ethical Centre of Medicine","authors":"Ian Io Lei MD ,&nbsp;Wojciech Marlicz MD, PhD ,&nbsp;Ramesh P. Arasaradnam MD, PhD ,&nbsp;Anastasios Koulaouzidis MD, PhD","doi":"10.1016/j.mcpdig.2025.100310","DOIUrl":"10.1016/j.mcpdig.2025.100310","url":null,"abstract":"","PeriodicalId":74127,"journal":{"name":"Mayo Clinic Proceedings. Digital health","volume":"4 1","pages":"Article 100310"},"PeriodicalIF":0.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
DD-NeuralNet: Dual-Domain Neural Network for Enhanced Multi-Lead ECG Decision Support 双域神经网络增强多导联心电决策支持
Pub Date : 2025-12-01 DOI: 10.1016/j.mcpdig.2025.100289
Weiguo Cao PhD , Jianfu Li PhD , Cui Tao PhD
{"title":"DD-NeuralNet: Dual-Domain Neural Network for Enhanced Multi-Lead ECG Decision Support","authors":"Weiguo Cao PhD ,&nbsp;Jianfu Li PhD ,&nbsp;Cui Tao PhD","doi":"10.1016/j.mcpdig.2025.100289","DOIUrl":"10.1016/j.mcpdig.2025.100289","url":null,"abstract":"","PeriodicalId":74127,"journal":{"name":"Mayo Clinic Proceedings. Digital health","volume":"3 4","pages":"Article 100289"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Foundation Models as a New Portable Standard in Local Risk Stratification for Emergency Surgery 基础模型作为急诊外科局部风险分层的便携式新标准
Pub Date : 2025-12-01 DOI: 10.1016/j.mcpdig.2025.100284
Chris Varghese MBChB, BMedSc(Hons) , Elizabeth B. Habermann PhD , Kristine T. Hanson MPH , Ashok Choudhary PhD , Hojjat Salehinejad PhD , Cornelius A. Thiels DO, MBA
{"title":"Foundation Models as a New Portable Standard in Local Risk Stratification for Emergency Surgery","authors":"Chris Varghese MBChB, BMedSc(Hons) ,&nbsp;Elizabeth B. Habermann PhD ,&nbsp;Kristine T. Hanson MPH ,&nbsp;Ashok Choudhary PhD ,&nbsp;Hojjat Salehinejad PhD ,&nbsp;Cornelius A. Thiels DO, MBA","doi":"10.1016/j.mcpdig.2025.100284","DOIUrl":"10.1016/j.mcpdig.2025.100284","url":null,"abstract":"","PeriodicalId":74127,"journal":{"name":"Mayo Clinic Proceedings. Digital health","volume":"3 4","pages":"Article 100284"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
From CNN to Vision Foundation Models and LLMs: A Multimodal Framework for Pathology Image Retrieval and Auto-Captioning 从CNN到视觉基础模型和llm:病理图像检索和自动标注的多模态框架
Pub Date : 2025-12-01 DOI: 10.1016/j.mcpdig.2025.100291
Md. Enamul Hoq , Wataru Uegami , Saghir Alfasly , Sahar Rahimi Malakshan , Ghazal Alabtah , Armita Kazemi , Alex T. Schmitgen , Fred Prior , H.R. Tizhoosh
{"title":"From CNN to Vision Foundation Models and LLMs: A Multimodal Framework for Pathology Image Retrieval and Auto-Captioning","authors":"Md. Enamul Hoq ,&nbsp;Wataru Uegami ,&nbsp;Saghir Alfasly ,&nbsp;Sahar Rahimi Malakshan ,&nbsp;Ghazal Alabtah ,&nbsp;Armita Kazemi ,&nbsp;Alex T. Schmitgen ,&nbsp;Fred Prior ,&nbsp;H.R. Tizhoosh","doi":"10.1016/j.mcpdig.2025.100291","DOIUrl":"10.1016/j.mcpdig.2025.100291","url":null,"abstract":"","PeriodicalId":74127,"journal":{"name":"Mayo Clinic Proceedings. Digital health","volume":"3 4","pages":"Article 100291"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145786568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Mayo Clinic Proceedings. Digital health
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