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Hou H, Zhang R, Li J. Artificial intelligence in the clinical laboratory. Clin Chim Acta 2024; 559:119724. [PMID: 38734225 DOI: 10.1016/j.cca.2024.119724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/13/2024]
Abstract
Laboratory medicine has become a highly automated medical discipline. Nowadays, artificial intelligence (AI) applied to laboratory medicine is also gaining more and more attention, which can optimize the entire laboratory workflow and even revolutionize laboratory medicine in the future. However, only a few commercially available AI models are currently approved for use in clinical laboratories and have drawbacks such as high cost, lack of accuracy, and the need for manual review of model results. Furthermore, there are a limited number of literature reviews that comprehensively address the research status, challenges, and future opportunities of AI applications in laboratory medicine. Our article begins with a brief introduction to AI and some of its subsets, then reviews some AI models that are currently being used in clinical laboratories or that have been described in emerging studies, and explains the existing challenges associated with their application and possible solutions, finally provides insights into the future opportunities of the field. We highlight the current status of implementation and potential applications of AI models in different stages of the clinical testing process.
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Affiliation(s)
- Hanjing Hou
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China; National Center for Clinical Laboratories, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China; Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, PR China
| | - Rui Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China; National Center for Clinical Laboratories, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China; Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, PR China.
| | - Jinming Li
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, PR China; National Center for Clinical Laboratories, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China; Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, PR China.
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2
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Virdee PS, Collins KK, Friedemann Smith C, Yang X, Zhu S, Roberts SE, Roberts N, Oke JL, Bankhead C, Perera R, Hobbs FDR, Nicholson BD. The Association between Blood Test Trends and Undiagnosed Cancer: A Systematic Review and Critical Appraisal. Cancers (Basel) 2024; 16:1692. [PMID: 38730644 PMCID: PMC11083147 DOI: 10.3390/cancers16091692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/20/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Clinical guidelines include monitoring blood test abnormalities to identify patients at increased risk of undiagnosed cancer. Noting blood test changes over time may improve cancer risk stratification by considering a patient's individual baseline and important changes within the normal range. We aimed to review the published literature to understand the association between blood test trends and undiagnosed cancer. MEDLINE and EMBASE were searched until 15 May 2023 for studies assessing the association between blood test trends and undiagnosed cancer. We used descriptive summaries and narratively synthesised studies. We included 29 articles. Common blood tests were haemoglobin (24%, n = 7), C-reactive protein (17%, n = 5), and fasting blood glucose (17%, n = 5), and common cancers were pancreatic (29%, n = 8) and colorectal (17%, n = 5). Of the 30 blood tests studied, an increasing trend in eight (27%) was associated with eight cancer types, and a decreasing trend in 17 (57%) with 10 cancer types. No association was reported between trends in 11 (37%) tests and breast, bile duct, glioma, haematological combined, liver, prostate, or thyroid cancers. Our review highlights trends in blood tests that could facilitate the identification of individuals at increased risk of undiagnosed cancer. For most possible combinations of tests and cancers, there was limited or no evidence.
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Affiliation(s)
- Pradeep S. Virdee
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (K.K.C.); (C.F.S.); (S.Z.); (J.L.O.); (C.B.); (R.P.); (F.R.H.); (B.D.N.)
| | - Kiana K. Collins
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (K.K.C.); (C.F.S.); (S.Z.); (J.L.O.); (C.B.); (R.P.); (F.R.H.); (B.D.N.)
| | - Claire Friedemann Smith
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (K.K.C.); (C.F.S.); (S.Z.); (J.L.O.); (C.B.); (R.P.); (F.R.H.); (B.D.N.)
| | - Xin Yang
- St Edmund Hall, University of Oxford, Oxford OX1 4AR, UK;
| | - Sufen Zhu
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (K.K.C.); (C.F.S.); (S.Z.); (J.L.O.); (C.B.); (R.P.); (F.R.H.); (B.D.N.)
| | - Sophie E. Roberts
- Medical Sciences Division, St Peters College, University of Oxford, Oxford OX1 2DL, UK;
| | - Nia Roberts
- Bodleian Health Care Libraries, Oxford OX3 7DQ, UK;
| | - Jason L. Oke
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (K.K.C.); (C.F.S.); (S.Z.); (J.L.O.); (C.B.); (R.P.); (F.R.H.); (B.D.N.)
| | - Clare Bankhead
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (K.K.C.); (C.F.S.); (S.Z.); (J.L.O.); (C.B.); (R.P.); (F.R.H.); (B.D.N.)
| | - Rafael Perera
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (K.K.C.); (C.F.S.); (S.Z.); (J.L.O.); (C.B.); (R.P.); (F.R.H.); (B.D.N.)
| | - FD Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (K.K.C.); (C.F.S.); (S.Z.); (J.L.O.); (C.B.); (R.P.); (F.R.H.); (B.D.N.)
| | - Brian D. Nicholson
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (K.K.C.); (C.F.S.); (S.Z.); (J.L.O.); (C.B.); (R.P.); (F.R.H.); (B.D.N.)
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Çubukçu HC, Topcu Dİ, Yenice S. Machine learning-based clinical decision support using laboratory data. Clin Chem Lab Med 2024; 62:793-823. [PMID: 38015744 DOI: 10.1515/cclm-2023-1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/17/2023] [Indexed: 11/30/2023]
Abstract
Artificial intelligence (AI) and machine learning (ML) are becoming vital in laboratory medicine and the broader context of healthcare. In this review article, we summarized the development of ML models and how they contribute to clinical laboratory workflow and improve patient outcomes. The process of ML model development involves data collection, data cleansing, feature engineering, model development, and optimization. These models, once finalized, are subjected to thorough performance assessments and validations. Recently, due to the complexity inherent in model development, automated ML tools were also introduced to streamline the process, enabling non-experts to create models. Clinical Decision Support Systems (CDSS) use ML techniques on large datasets to aid healthcare professionals in test result interpretation. They are revolutionizing laboratory medicine, enabling labs to work more efficiently with less human supervision across pre-analytical, analytical, and post-analytical phases. Despite contributions of the ML tools at all analytical phases, their integration presents challenges like potential model uncertainties, black-box algorithms, and deskilling of professionals. Additionally, acquiring diverse datasets is hard, and models' complexity can limit clinical use. In conclusion, ML-based CDSS in healthcare can greatly enhance clinical decision-making. However, successful adoption demands collaboration among professionals and stakeholders, utilizing hybrid intelligence, external validation, and performance assessments.
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Affiliation(s)
- Hikmet Can Çubukçu
- General Directorate of Health Services, Rare Diseases Department, Turkish Ministry of Health, Ankara, Türkiye
- Hacettepe University Institute of Informatics, Ankara, Türkiye
| | - Deniz İlhan Topcu
- Health Sciences University İzmir Tepecik Education and Research Hospital, Medical Biochemistry, İzmir, Türkiye
| | - Sedef Yenice
- Florence Nightingale Hospital, Istanbul, Türkiye
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Balagopalan A, Baldini I, Celi LA, Gichoya J, McCoy LG, Naumann T, Shalit U, van der Schaar M, Wagstaff KL. Machine learning for healthcare that matters: Reorienting from technical novelty to equitable impact. PLOS DIGITAL HEALTH 2024; 3:e0000474. [PMID: 38620047 PMCID: PMC11018283 DOI: 10.1371/journal.pdig.0000474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/18/2024] [Indexed: 04/17/2024]
Abstract
Despite significant technical advances in machine learning (ML) over the past several years, the tangible impact of this technology in healthcare has been limited. This is due not only to the particular complexities of healthcare, but also due to structural issues in the machine learning for healthcare (MLHC) community which broadly reward technical novelty over tangible, equitable impact. We structure our work as a healthcare-focused echo of the 2012 paper "Machine Learning that Matters", which highlighted such structural issues in the ML community at large, and offered a series of clearly defined "Impact Challenges" to which the field should orient itself. Drawing on the expertise of a diverse and international group of authors, we engage in a narrative review and examine issues in the research background environment, training processes, evaluation metrics, and deployment protocols which act to limit the real-world applicability of MLHC. Broadly, we seek to distinguish between machine learning ON healthcare data and machine learning FOR healthcare-the former of which sees healthcare as merely a source of interesting technical challenges, and the latter of which regards ML as a tool in service of meeting tangible clinical needs. We offer specific recommendations for a series of stakeholders in the field, from ML researchers and clinicians, to the institutions in which they work, and the governments which regulate their data access.
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Affiliation(s)
- Aparna Balagopalan
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology; Cambridge, Massachusetts, United States of America
| | - Ioana Baldini
- IBM Research; Yorktown Heights, New York, United States of America
| | - Leo Anthony Celi
- Laboratory for Computational Physiology, Massachusetts Institute of Technology; Cambridge, Massachusetts, United States of America
- Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center; Boston, Massachusetts, United States of America
- Department of Biostatistics, Harvard T.H. Chan School of Public Health; Boston, Massachusetts, United States of America
| | - Judy Gichoya
- Department of Radiology and Imaging Sciences, School of Medicine, Emory University; Atlanta, Georgia, United States of America
| | - Liam G. McCoy
- Division of Neurology, Department of Medicine, University of Alberta; Edmonton, Alberta, Canada
| | - Tristan Naumann
- Microsoft Research; Redmond, Washington, United States of America
| | - Uri Shalit
- The Faculty of Data and Decision Sciences, Technion; Haifa, Israel
| | - Mihaela van der Schaar
- Department of Applied Mathematics and Theoretical Physics, University of Cambridge; Cambridge, United Kingdom
- The Alan Turing Institute; London, United Kingdom
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Bernardi S, Vallati M, Gatta R. Artificial Intelligence-Based Management of Adult Chronic Myeloid Leukemia: Where Are We and Where Are We Going? Cancers (Basel) 2024; 16:848. [PMID: 38473210 DOI: 10.3390/cancers16050848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/08/2024] [Accepted: 02/15/2024] [Indexed: 03/14/2024] Open
Abstract
Artificial intelligence (AI) is emerging as a discipline capable of providing significant added value in Medicine, in particular in radiomic, imaging analysis, big dataset analysis, and also for generating virtual cohort of patients. However, in coping with chronic myeloid leukemia (CML), considered an easily managed malignancy after the introduction of TKIs which strongly improved the life expectancy of patients, AI is still in its infancy. Noteworthy, the findings of initial trials are intriguing and encouraging, both in terms of performance and adaptability to different contexts in which AI can be applied. Indeed, the improvement of diagnosis and prognosis by leveraging biochemical, biomolecular, imaging, and clinical data can be crucial for the implementation of the personalized medicine paradigm or the streamlining of procedures and services. In this review, we present the state of the art of AI applications in the field of CML, describing the techniques and objectives, and with a general focus that goes beyond Machine Learning (ML), but instead embraces the wider AI field. The present scooping review spans on publications reported in Pubmed from 2003 to 2023, and resulting by searching "chronic myeloid leukemia" and "artificial intelligence". The time frame reflects the real literature production and was not restricted. We also take the opportunity for discussing the main pitfalls and key points to which AI must respond, especially considering the critical role of the 'human' factor, which remains key in this domain.
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Affiliation(s)
- Simona Bernardi
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
- CREA-Centro di Ricerca Emato-Oncologica AIL, ASST Spedali Civili of Brescia, 25123 Brescia, Italy
| | - Mauro Vallati
- School of Computing and Engineering, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Roberto Gatta
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
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Elhadary M, Elsabagh AA, Ferih K, Elsayed B, Elshoeibi AM, Kaddoura R, Akiki S, Ahmed K, Yassin M. Applications of Machine Learning in Chronic Myeloid Leukemia. Diagnostics (Basel) 2023; 13:diagnostics13071330. [PMID: 37046547 PMCID: PMC10093579 DOI: 10.3390/diagnostics13071330] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 04/14/2023] Open
Abstract
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by dysregulated growth and the proliferation of myeloid cells in the bone marrow caused by the BCR-ABL1 fusion gene. Clinically, CML demonstrates an increased production of mature and maturing granulocytes, mainly neutrophils. When a patient is suspected to have CML, peripheral blood smears and bone marrow biopsies may be manually examined by a hematologist. However, confirmatory testing for the BCR-ABL1 gene is still needed to confirm the diagnosis. Despite tyrosine kinase inhibitors (TKIs) being the mainstay of treatment for patients with CML, different agents should be used in different patients given their stage of disease and comorbidities. Moreover, some patients do not respond well to certain agents and some need more aggressive courses of therapy. Given the innovations and development that machine learning (ML) and artificial intelligence (AI) have undergone over the years, multiple models and algorithms have been put forward to help in the assessment and treatment of CML. In this review, we summarize the recent studies utilizing ML algorithms in patients with CML. The search was conducted on the PubMed/Medline and Embase databases and yielded 66 full-text articles and abstracts, out of which 11 studies were included after screening against the inclusion criteria. The studies included show potential for the clinical implementation of ML models in the diagnosis, risk assessment, and treatment processes of patients with CML.
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Affiliation(s)
- Mohamed Elhadary
- College of Medicine, QU Health, Qatar University, Doha 2713, Qatar
| | | | - Khaled Ferih
- College of Medicine, QU Health, Qatar University, Doha 2713, Qatar
| | - Basel Elsayed
- College of Medicine, QU Health, Qatar University, Doha 2713, Qatar
| | | | - Rasha Kaddoura
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation (HMC), Doha 3050, Qatar
| | - Susanna Akiki
- Diagnostic Genomic Division, Hamad Medical Corporation (HMC), Doha 3050, Qatar
| | - Khalid Ahmed
- Department of Hematology, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha 3050, Qatar
| | - Mohamed Yassin
- Hematology Section, Medical Oncology, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha 3050, Qatar
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Assanto GM, Scalzulli E, Carmosino I, Martelli M, Breccia M. From bench to bedside: bridging the gaps in best practices for real-world chronic myeloid leukemia care. Expert Rev Hematol 2022; 15:963-971. [PMID: 36305791 DOI: 10.1080/17474086.2022.2142112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Although tyrosine kinase inhibitors (TKIs) determined an improvement of responses and overall survival (OS) in chronic phase chronic myeloid leukemia (CP-CML) patients, some patients still fail the achievement of important milestones. AREAS COVERED In this review, we focus on the need of appropriate molecular and mutational monitoring during TKI treatment with new laboratory tools and on new compounds developed to counteract the unmet clinical need in CP-CML. EXPERT OPINION The appropriate identification of BCR::ABL1 dependent and independent mechanisms of resistance with Next Generation Sequencing (NGS) and digital droplet PCR (ddPCR) can allow to improve the therapeutic strategies and prevent the onset of a failure to treatment. New compounds have been recently approved or are still in investigational trials to improve the response in some critical forms of resistance and/or intolerance to available TKIs.
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Affiliation(s)
- Giovanni Manfredi Assanto
- Department Cellular Biotechnol & Hematol, Az. Policlinico Umberto I-Sapienza University, Rome, Italy
| | - Emilia Scalzulli
- Department Cellular Biotechnol & Hematol, Az. Policlinico Umberto I-Sapienza University, Rome, Italy
| | - Ida Carmosino
- Department Cellular Biotechnol & Hematol, Az. Policlinico Umberto I-Sapienza University, Rome, Italy
| | - Maurizio Martelli
- Department Cellular Biotechnol & Hematol, Az. Policlinico Umberto I-Sapienza University, Rome, Italy
| | - Massimo Breccia
- Department Cellular Biotechnol & Hematol, Az. Policlinico Umberto I-Sapienza University, Rome, Italy
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Shanbehzadeh M, Afrash MR, Mirani N, Kazemi-Arpanahi H. Comparing machine learning algorithms to predict 5-year survival in patients with chronic myeloid leukemia. BMC Med Inform Decis Mak 2022; 22:236. [PMID: 36068539 PMCID: PMC9450320 DOI: 10.1186/s12911-022-01980-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/30/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Chronic myeloid leukemia (CML) is a myeloproliferative disorder resulting from the translocation of chromosomes 19 and 22. CML includes 15–20% of all cases of leukemia. Although bone marrow transplant and, more recently, tyrosine kinase inhibitors (TKIs) as a first-line treatment have significantly prolonged survival in CML patients, accurate prediction using available patient-level factors can be challenging. We intended to predict 5-year survival among CML patients via eight machine learning (ML) algorithms and compare their performance.
Methods The data of 837 CML patients were retrospectively extracted and randomly split into training and test segments (70:30 ratio). The outcome variable was 5-year survival with potential values of alive or deceased. The dataset for the full features and important features selected by minimal redundancy maximal relevance (mRMR) feature selection were fed into eight ML techniques, including eXtreme gradient boosting (XGBoost), multilayer perceptron (MLP), pattern recognition network, k-nearest neighborhood (KNN), probabilistic neural network, support vector machine (SVM) (kernel = linear), SVM (kernel = RBF), and J-48. The scikit-learn library in Python was used to implement the models. Finally, the performance of the developed models was measured using some evaluation criteria with 95% confidence intervals (CI). Results Spleen palpable, age, and unexplained hemorrhage were identified as the top three effective features affecting CML 5-year survival. The performance of ML models using the selected-features was superior to that of the full-features dataset. Among the eight ML algorithms, SVM (kernel = RBF) had the best performance in tenfold cross-validation with an accuracy of 85.7%, specificity of 85%, sensitivity of 86%, F-measure of 87%, kappa statistic of 86.1%, and area under the curve (AUC) of 85% for the selected-features. Using the full-features dataset yielded an accuracy of 69.7%, specificity of 69.1%, sensitivity of 71.3%, F-measure of 72%, kappa statistic of 75.2%, and AUC of 70.1%. Conclusions Accurate prediction of the survival likelihood of CML patients can inform caregivers to promote patient prognostication and choose the best possible treatment path. While external validation is required, our developed models will offer customized treatment and may guide the prescription of personalized medicine for CML patients.
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Affiliation(s)
- Mostafa Shanbehzadeh
- Department of Health Information Technology, Faculty of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
| | - Mohammad Reza Afrash
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nader Mirani
- Department of Treatment, Head of the Medical Truism, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hadi Kazemi-Arpanahi
- Department of Health Information Technology, Abadan University of Medical Sciences, Abadan, Iran. .,Department of Student Research Committee, Abadan University of Medical Sciences, Abadan, Iran.
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El Alaoui Y, Elomri A, Qaraqe M, Padmanabhan R, Yasin Taha R, El Omri H, El Omri A, Aboumarzouk O. A Review of Artificial Intelligence Applications in Hematology Management: Current Practices and Future Prospects. J Med Internet Res 2022; 24:e36490. [PMID: 35819826 PMCID: PMC9328784 DOI: 10.2196/36490] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 05/14/2022] [Accepted: 05/29/2022] [Indexed: 12/23/2022] Open
Abstract
Background Machine learning (ML) and deep learning (DL) methods have recently garnered a great deal of attention in the field of cancer research by making a noticeable contribution to the growth of predictive medicine and modern oncological practices. Considerable focus has been particularly directed toward hematologic malignancies because of the complexity in detecting early symptoms. Many patients with blood cancer do not get properly diagnosed until their cancer has reached an advanced stage with limited treatment prospects. Hence, the state-of-the-art revolves around the latest artificial intelligence (AI) applications in hematology management. Objective This comprehensive review provides an in-depth analysis of the current AI practices in the field of hematology. Our objective is to explore the ML and DL applications in blood cancer research, with a special focus on the type of hematologic malignancies and the patient’s cancer stage to determine future research directions in blood cancer. Methods We searched a set of recognized databases (Scopus, Springer, and Web of Science) using a selected number of keywords. We included studies written in English and published between 2015 and 2021. For each study, we identified the ML and DL techniques used and highlighted the performance of each model. Results Using the aforementioned inclusion criteria, the search resulted in 567 papers, of which 144 were selected for review. Conclusions The current literature suggests that the application of AI in the field of hematology has generated impressive results in the screening, diagnosis, and treatment stages. Nevertheless, optimizing the patient’s pathway to treatment requires a prior prediction of the malignancy based on the patient’s symptoms or blood records, which is an area that has still not been properly investigated.
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Affiliation(s)
- Yousra El Alaoui
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Adel Elomri
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Marwa Qaraqe
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Regina Padmanabhan
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Ruba Yasin Taha
- National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Halima El Omri
- National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Abdelfatteh El Omri
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Omar Aboumarzouk
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar.,College of Medicine, Qatar University, Doha, Qatar.,College of Medicine, University of Glasgow, Glasgow, United Kingdom
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Afrash MR, Shanbehzadeh M, Kazemi-Arpanahi H. Design and Development of an Intelligent System for Predicting 5-Year Survival in Gastric Cancer. CLINICAL MEDICINE INSIGHTS: ONCOLOGY 2022; 16:11795549221116833. [PMID: 36035639 PMCID: PMC9403452 DOI: 10.1177/11795549221116833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Gastric cancer remains one of the leading causes of worldwide cancer-specific
deaths. Accurately predicting the survival likelihood of gastric cancer
patients can inform caregivers to boost patient prognostication and choose
the best possible treatment path. This study intends to develop an
intelligent system based on machine learning (ML) algorithms for predicting
the 5-year survival status in gastric cancer patients. Methods: A data set that includes the records of 974 gastric cancer patients
retrospectively was used. First, the most important predictors were
recognized using the Boruta feature selection algorithm. Five classifiers,
including J48 decision tree (DT), support vector machine (SVM) with radial
basic function (RBF) kernel, bootstrap aggregating (Bagging), hist gradient
boosting (HGB), and adaptive boosting (AdaBoost), were trained for
predicting gastric cancer survival. The performance of the used techniques
was evaluated with specificity, sensitivity, likelihood ratio, and total
accuracy. Finally, the system was developed according to the best model. Results: The stage, position, and size of tumor were selected as the 3 top predictors
for gastric cancer survival. Among the 6 selected ML algorithms, the HGB
classifier with the mean accuracy, mean specificity, mean sensitivity, mean
area under the curve, and mean F1-score of 88.37%, 86.24%, 89.72%, 88.11%,
and 89.91%, respectively, gained the best performance. Conclusions: The ML models can accurately predict the 5-year survival and potentially act
as a customized recommender for decision-making in gastric cancer patients.
The developed system in our study can improve the quality of treatment,
patient safety, and survival rates; it may guide prescribing more
personalized medicine.
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Affiliation(s)
- Mohammad Reza Afrash
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Shanbehzadeh
- Department of Health Information Technology, School of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
| | - Hadi Kazemi-Arpanahi
- Department of Health Information Technology, Abadan University of Medical Sciences, Abadan, Iran
- Student Research Committee, Abadan University of Medical Sciences, Abadan, Iran
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Resistance to Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia-From Molecular Mechanisms to Clinical Relevance. Cancers (Basel) 2021; 13:cancers13194820. [PMID: 34638304 PMCID: PMC8508378 DOI: 10.3390/cancers13194820] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 01/18/2023] Open
Abstract
Simple Summary Chronic myeloid leukemia (CML) is a myeloproliferative neoplasia associated with a molecular alteration, the fusion gene BCR-ABL1, that encodes the tyrosine kinase oncoprotein BCR-ABL1. This led to the development of tyrosine kinase inhibitors (TKI), with Imatinib being the first TKI approved. Although the vast majority of CML patients respond to Imatinib, resistance to this targeted therapy contributes to therapeutic failure and relapse. Here we review the molecular mechanisms and other factors (e.g., patient adherence) involved in TKI resistance, the methodologies to access these mechanisms, and the possible therapeutic approaches to circumvent TKI resistance in CML. Abstract Resistance to targeted therapies is a complex and multifactorial process that culminates in the selection of a cancer clone with the ability to evade treatment. Chronic myeloid leukemia (CML) was the first malignancy recognized to be associated with a genetic alteration, the t(9;22)(q34;q11). This translocation originates the BCR-ABL1 fusion gene, encoding the cytoplasmic chimeric BCR-ABL1 protein that displays an abnormally high tyrosine kinase activity. Although the vast majority of patients with CML respond to Imatinib, a tyrosine kinase inhibitor (TKI), resistance might occur either de novo or during treatment. In CML, the TKI resistance mechanisms are usually subdivided into BCR-ABL1-dependent and independent mechanisms. Furthermore, patients’ compliance/adherence to therapy is critical to CML management. Techniques with enhanced sensitivity like NGS and dPCR, the use of artificial intelligence (AI) techniques, and the development of mathematical modeling and computational prediction methods could reveal the underlying mechanisms of drug resistance and facilitate the design of more effective treatment strategies for improving drug efficacy in CML patients. Here we review the molecular mechanisms and other factors involved in resistance to TKIs in CML and the new methodologies to access these mechanisms, and the therapeutic approaches to circumvent TKI resistance.
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