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Li Pomi F, Papa V, Borgia F, Vaccaro M, Pioggia G, Gangemi S. Artificial Intelligence: A Snapshot of Its Application in Chronic Inflammatory and Autoimmune Skin Diseases. Life (Basel) 2024; 14:516. [PMID: 38672786 PMCID: PMC11051135 DOI: 10.3390/life14040516] [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: 03/29/2024] [Revised: 04/10/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Immuno-correlated dermatological pathologies refer to skin disorders that are closely associated with immune system dysfunction or abnormal immune responses. Advancements in the field of artificial intelligence (AI) have shown promise in enhancing the diagnosis, management, and assessment of immuno-correlated dermatological pathologies. This intersection of dermatology and immunology plays a pivotal role in comprehending and addressing complex skin disorders with immune system involvement. The paper explores the knowledge known so far and the evolution and achievements of AI in diagnosis; discusses segmentation and the classification of medical images; and reviews existing challenges, in immunological-related skin diseases. From our review, the role of AI has emerged, especially in the analysis of images for both diagnostic and severity assessment purposes. Furthermore, the possibility of predicting patients' response to therapies is emerging, in order to create tailored therapies.
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Affiliation(s)
- Federica Li Pomi
- Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, 90127 Palermo, Italy;
| | - Vincenzo Papa
- Department of Clinical and Experimental Medicine, School and Operative Unit of Allergy and Clinical Immunology, University of Messina, 98125 Messina, Italy; (V.P.); (S.G.)
| | - Francesco Borgia
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, 98125 Messina, Italy;
| | - Mario Vaccaro
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, 98125 Messina, Italy;
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy;
| | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, School and Operative Unit of Allergy and Clinical Immunology, University of Messina, 98125 Messina, Italy; (V.P.); (S.G.)
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Cronin A, Tkaczyk ER, Hussain I, Bowden A, Saknite I. Effect of camera distance and angle on color of diverse skin tone-based standards in smartphone photos. JOURNAL OF BIOPHOTONICS 2023; 16:e202200381. [PMID: 36772956 PMCID: PMC10247498 DOI: 10.1002/jbio.202200381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 06/07/2023]
Abstract
Accurate and reproducible color capture is vital in medical photography. Camera distance and angle are particularly important as they are highly variable in a clinical setting. To account for variability in illumination, camera technology, and geometric effects, color standards are often used for color correction. To explore how geometry affects color, we quantified the change in CIELAB color value of a color standard for diverse skin tones at varying smartphone camera distances and angles. Whereas both chromaticity (a* and b*) and lightness (L*) were affected by angle, distance only affected L* (standard error of measurement, SEM > 1 CIELAB unit). Flash usage did not generally reduce distance and angle associated variability. Compared to compressed (JPG) format, raw (DNG) images had decreased median variability across different distances and angles. These findings suggest that in medical photography, inconsistent camera distance and angle can increase variability in photographed skin appearance over time.
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Affiliation(s)
- Austin Cronin
- Dermatology Service, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, Tennessee, USA
- Department of Dermatology, Vanderbilt Dermatology Translational Research Clinic, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Eric R. Tkaczyk
- Dermatology Service, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, Tennessee, USA
- Department of Dermatology, Vanderbilt Dermatology Translational Research Clinic, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Iftak Hussain
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Audrey Bowden
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Inga Saknite
- Department of Dermatology, Vanderbilt Dermatology Translational Research Clinic, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Riga, Latvia
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Rashid F, Jamayet NB, Farook TH, AL-Rawas M, Barman A, Johari Y, Noorani TY, Abdullah JY, Eusufzai SZ, Alam MK. Color variations during digital imaging of facial prostheses subjected to unfiltered ambient light and image calibration techniques within dental clinics: An in vitro analysis. PLoS One 2022; 17:e0273029. [PMID: 36037161 PMCID: PMC9423681 DOI: 10.1371/journal.pone.0273029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 08/01/2022] [Indexed: 12/04/2022] Open
Abstract
Background The study aimed to evaluate 1) the amount of color variations presents within clinical images of maxillofacial prosthetic silicone specimens when photographed under different clinically relevant ambient lighting conditions, and 2) whether white balance calibration (WBC) methods were able to mitigate variations in ambient lighting. Methods 432 measurements were acquired from standardized images of the pigmented prosthetic silicone specimens within different ambient lighting conditions (i.e., 2 windowed and 2 windowless clinics) at noon with no light modifying apparatus. The specimens were photographed once without any white balance calibration (raw), then independently alongside an 18% neutral gray card and Macbeth color chart for calibration in a post-processing (PPWBC) software, and once after camera calibration (CWBC) using a gray card. The LAB color values were extracted from the images and color variations (ΔE) were calculated after referring to the corresponding spectrophotometric values as control. Results Images in windowless and windowed clinics exhibited highly significant differences (p < 0.001) with spectrophotometer (control). CWBC demonstrated no significant differences (p > 0.05) in LAB values across windowed clinics. PPWBC using Macbeth color chart produced no significant differences for a* values (p > 0.05) across all clinics while PPWBC by gray card showed no significant differences (p > 0.05) in LAB values when only similar clinics (either windowed or windowless) were compared. Conclusion Significant color variations were present for maxillofacial prosthetic specimens owing to natural ambient light. CWBC and PPWBC using color charts were more suitable for color correction across windowed clinics while CWBC and PPWBC using gray cards had better outcomes across windowless setups.
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Affiliation(s)
- Farah Rashid
- School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Nafij Bin Jamayet
- Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
- * E-mail:
| | | | - Matheel AL-Rawas
- Prosthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Aparna Barman
- School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Yanti Johari
- Prosthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Johari Yap Abdullah
- Craniofacial Imaging and Additive Manufacturing Laboratory, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | | | - Mohammad Khursheed Alam
- Orthodontics, Department of Preventive Dental Science, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
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de Brito M, Stevens BR, Yiu ZZN. Can artificial intelligence be used for accurate remote scoring of the Psoriasis Area and Severity Index (PASI) in adult patients with plaque psoriasis? A Critically Appraised Topic. Br J Dermatol 2021; 185:1262-1264. [PMID: 34351616 DOI: 10.1111/bjd.20663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 07/26/2021] [Accepted: 07/31/2021] [Indexed: 11/26/2022]
Abstract
A 47-year-old man with chronic plaque psoriasis and type II diabetes mellitus on ustekinumab 45mg 12 weekly injections, his first biologic therapy, was switched to adalimumab 40mg alternate weeks (10/02/2020) when his Psoriasis Area and Severity Index (PASI) was 11.4 due to loss of effectiveness. Due to the COVID-19 outbreak, the U.K Prime Minister advised clinically vulnerable people, including people on immunosuppressive medication with comorbidities including diabetes, to stay home avoiding face-to-face contact (23/03/2020). We performed a Critically Appraised Topic review to understand whether it was possible to remotely assess his response to adalimumab with AI assistance.
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Affiliation(s)
- M de Brito
- Centre for Dermatology Research, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, M13 9PT
| | - B R Stevens
- Centre for Dermatology Research, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, M13 9PT
| | - Z Z N Yiu
- Centre for Dermatology Research, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, M13 9PT
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Yu K, Syed MN, Bernardis E, Gelfand JM. Machine Learning Applications in the Evaluation and Management of Psoriasis: A Systematic Review. ACTA ACUST UNITED AC 2021; 5:147-159. [PMID: 33733038 PMCID: PMC7963214 DOI: 10.1177/2475530320950267] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background Machine learning (ML), a subset of artificial intelligence (AI) that aims to teach machines to automatically learn tasks by inferring patterns from data, holds significant promise to aid psoriasis care. Applications include evaluation of skin images for screening and diagnosis as well as clinical management including treatment and complication prediction. Objective To summarize literature on ML applications to psoriasis evaluation and management and to discuss challenges and opportunities for future advances. Methods We searched MEDLINE, Google Scholar, ACM Digital Library, and IEEE Xplore for peer-reviewed publications published in English through December 1, 2019. Our search queries identified publications with any of the 10 computing-related keywords and "psoriasis" in the title and/or abstract. Results Thirty-three studies were identified. Articles were organized by topic and synthesized as evaluation- or management-focused articles covering 5 content categories: (A) Evaluation using skin images: (1) identification and differential diagnosis of psoriasis lesions, (2) lesion segmentation, and (3) lesion severity and area scoring; (B) clinical management: (1) prediction of complications and (2) treatment. Conclusion Machine learning has significant potential to aid psoriasis evaluation and management. Current topics popular in ML research on psoriasis are the evaluation of medical images, prediction of complications, and treatment discovery. For patients to derive the greatest benefit from ML advancements, it is helpful for dermatologists to have an understanding of ML and how it can effectively aid their assessments and decision-making.
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Affiliation(s)
- Kimberley Yu
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Maha N Syed
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Elena Bernardis
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Joel M Gelfand
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Cugmas B, Viškere D, Štruc E, Olivry T. Evaluation of Erythema Severity in Dermatoscopic Images of Canine Skin: Erythema Index Assessment and Image Sampling Reliability. SENSORS 2021; 21:s21041285. [PMID: 33670225 PMCID: PMC7916917 DOI: 10.3390/s21041285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 11/30/2022]
Abstract
The regular monitoring of erythema, one of the most important skin lesions in atopic (allergic) dogs, is essential for successful anti-allergic therapy. The smartphone-based dermatoscopy enables a convenient way to acquire quality images of erythematous skin. However, the image sampling to evaluate erythema severity is still done manually, introducing result variability. In this study, we investigated the correlation between the most popular erythema indices (EIs) and dermatologists’ erythema perception, and we measured intra- and inter-rater variability of the currently-used manual image-sampling methods (ISMs). We showed that the EIBRG, based on all three RGB (red, green, and blue) channels, performed the best with an average Spearman coefficient of 0.75 and a typical absolute disagreement of less than 14% with the erythema assessed by clinicians. On the other hand, two image-sampling methods, based on either selecting specific pixels or small skin areas, performed similarly well. They achieved high intra- and inter-rater reliability with the intraclass correlation coefficient (ICC) and Krippendorff’s alpha well above 0.90. These results indicated that smartphone-based dermatoscopy could be a convenient and precise way to evaluate skin erythema severity. However, better outlined, or even automated ISMs, are likely to improve the intra- and inter-rater reliability in severe erythematous cases.
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Affiliation(s)
- Blaž Cugmas
- Biophotonics laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, 19 Raiņa Blvd., LV-1586 Rīga, Latvia;
- Correspondence: ; Tel.: +371-67-033-848
| | - Daira Viškere
- Biophotonics laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, 19 Raiņa Blvd., LV-1586 Rīga, Latvia;
- Faculty of Veterinary Medicine, Latvia University of Life Sciences and Technologies, 8 Kristapa Helmaņa Str., LV-3004 Jelgava, Latvia
| | - Eva Štruc
- Vetamplify SIA, veterinary services, 57/59-32 Krišjāņa Valdemāra Str., LV-1010 Rīga, Latvia;
| | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, NC State University, 1060 William Moore Dr., Raleigh, NC 27607, USA;
- Comparative Medicine Institute, NC State University, Raleigh, NC 27606, USA
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Cugmas B, Olivry T. Evaluation of skin erythema severity by dermatoscopy in dogs with atopic dermatitis. Vet Dermatol 2021; 32:183-e46. [PMID: 33404104 DOI: 10.1111/vde.12932] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/25/2020] [Accepted: 09/30/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND To estimate the extent and severity of atopic dermatitis (AD)-related skin lesions, clinical trials enrolling dogs with AD often use categorical scales such as the Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-04) and Canine Atopic Dermatitis Lesion Index (CADLI). Despite recent progress in the standardization of these AD-grading scales, the evaluation of the severity of skin lesions (including erythema) remains subjective. OBJECTIVES To validate an optical set-up with a smartphone and a dermatoscope for the objective estimation of skin erythema severity in atopic dogs. ANIMALS Forty-three dogs with AD. METHODS AND MATERIALS An erythema index (EI) was calculated from calibrated skin images and compared to the dermatologist's erythema severity estimate using the erythema grading scale used in the CADESI-04, as well as an ad hoc Visual Analog Scale (VAS) with a continuous palette of red shades. RESULTS We found a strong correlation based on the Spearman rank correlation coefficient between all erythema valuations: CADESI-04 and VAS: 0.93 [95% CI: (0.85, 0.96)]; CADESI-04 and EI: 0.85 (0.72, 0.92); VAS and EI: 0.82 (0.67, 0.91). There was a good agreement between the objective EI and CADESI-04-based estimates because 71% of samples were classified in the same erythema severity category. When comparing the EI and the VAS, the standard deviation of misestimates was 12% (maximum 100%). CONCLUSIONS AND CLINICAL RELEVANCE The proposed optical set-up has the potential to make erythema severity estimation objective, thus leading to more reliable AD severity scales for the use in experimental canine AD models or in clinical trials enrolling atopic dogs.
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Affiliation(s)
- Blaž Cugmas
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, 19 Raiņa Bulvaris, Rīga, LV-1586, Latvia
| | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, NC State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.,Comparative Medicine Institute, NC State University, Raleigh, NC, 27606, USA
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Yélamos O, Alejo B, Ertekin SS, Villa-Crespo L, Zamora-Barquero S, Martinez N, Domínguez M, Iglesias P, Herrero A, Malvehy J, Puig S. Non-invasive clinical and microscopic evaluation of the response to treatment with clobetasol cream vs. calcipotriol/betamethasone dipropionate foam in mild to moderate plaque psoriasis: an investigator-initiated, phase IV, unicentric, open, randomized clinical trial. J Eur Acad Dermatol Venereol 2020; 35:143-149. [PMID: 32365242 PMCID: PMC7818495 DOI: 10.1111/jdv.16559] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 04/10/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Treatment response for psoriasis is typically evaluated using clinical scores. However, patients can relapse after clinical clearance, suggesting persistent inflammation. Dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) can non-invasively improve treatment response assessment. OBJECTIVES To compare the clinical and non-invasive microscopic features in a psoriatic target lesion treated with clobetasol cream or calcipotriol/betamethasone dipropionate foam (Cal/BD foam). METHODS Prospective, unicentric, open, randomized clinical trial comparing clinical data [total clinical score (TCS)] and microscopic data (dermoscopy, RCM and OCT) in psoriasis patients treated with clobetasol or Cal/BD foam. RESULTS We included 36 adult patients (22 men). At week 4, more patients treated with Cal/BD foam achieved TCS ≤1 than with clobetasol (63.2% vs. 18.8%, P = 0.016). Treatment satisfaction was higher with Cal/BD foam (P < 0.03). Microscopically, Cal/BD foam induced more reduction in epidermal thickness at week 4 (P < 0.049). Dilated horizontal blood vessels were more common with clobetasol than with Cal/BD foam at week 8 (69.2% vs. 31.2%, P = 0.159). If epidermal hyperplasia was noted at baseline, the response was poorer with clobetasol (P = 0.029). LIMITATIONS Small sample size, open study, imaging sampling bias. CONCLUSION Cal/BD foam is more effective than clobetasol, has better patient satisfaction and induces greater reduction in the hyperkeratosis/acanthosis, regardless of baseline epidermal hyperplasia.
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Affiliation(s)
- O Yélamos
- Dermatology Department, Hospital Clínic, Institut d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.,Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.,Department of Dermatology, Centro Médico Teknon - Quirónsalud, Barcelona, Spain
| | - B Alejo
- Dermatology Department, Hospital Clínic, Institut d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - S S Ertekin
- Dermatology Department, Hospital Clínic, Institut d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - L Villa-Crespo
- Dermatology Department, Hospital Clínic, Institut d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - S Zamora-Barquero
- Dermatology Department, Hospital Clínic, Institut d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - N Martinez
- Dermatology Department, Hospital Clínic, Institut d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - M Domínguez
- Dermatology Department, Hospital Clínic, Institut d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - P Iglesias
- Dermatology Department, Hospital Clínic, Institut d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - A Herrero
- Dermatology Department, Hospital Clínic, Institut d'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - J Malvehy
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain
| | - S Puig
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain
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Stafford IS, Kellermann M, Mossotto E, Beattie RM, MacArthur BD, Ennis S. A systematic review of the applications of artificial intelligence and machine learning in autoimmune diseases. NPJ Digit Med 2020; 3:30. [PMID: 32195365 PMCID: PMC7062883 DOI: 10.1038/s41746-020-0229-3] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 01/17/2020] [Indexed: 02/07/2023] Open
Abstract
Autoimmune diseases are chronic, multifactorial conditions. Through machine learning (ML), a branch of the wider field of artificial intelligence, it is possible to extract patterns within patient data, and exploit these patterns to predict patient outcomes for improved clinical management. Here, we surveyed the use of ML methods to address clinical problems in autoimmune disease. A systematic review was conducted using MEDLINE, embase and computers and applied sciences complete databases. Relevant papers included "machine learning" or "artificial intelligence" and the autoimmune diseases search term(s) in their title, abstract or key words. Exclusion criteria: studies not written in English, no real human patient data included, publication prior to 2001, studies that were not peer reviewed, non-autoimmune disease comorbidity research and review papers. 169 (of 702) studies met the criteria for inclusion. Support vector machines and random forests were the most popular ML methods used. ML models using data on multiple sclerosis, rheumatoid arthritis and inflammatory bowel disease were most common. A small proportion of studies (7.7% or 13/169) combined different data types in the modelling process. Cross-validation, combined with a separate testing set for more robust model evaluation occurred in 8.3% of papers (14/169). The field may benefit from adopting a best practice of validation, cross-validation and independent testing of ML models. Many models achieved good predictive results in simple scenarios (e.g. classification of cases and controls). Progression to more complex predictive models may be achievable in future through integration of multiple data types.
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Affiliation(s)
- I. S. Stafford
- Department of Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK
- Institute for Life Sciences, University of Southampton, Southampton, UK
| | - M. Kellermann
- Department of Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK
| | - E. Mossotto
- Department of Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK
- Institute for Life Sciences, University of Southampton, Southampton, UK
| | - R. M. Beattie
- Department of Paediatric Gastroenterology, Southampton Children’s Hospital, Southampton, UK
| | - B. D. MacArthur
- Institute for Life Sciences, University of Southampton, Southampton, UK
| | - S. Ennis
- Department of Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK
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Towbin AJ, Roth CJ, Bronkalla M, Cram D. Workflow Challenges of Enterprise Imaging: HIMSS-SIIM Collaborative White Paper. J Digit Imaging 2018; 29:574-82. [PMID: 27527613 PMCID: PMC5023531 DOI: 10.1007/s10278-016-9897-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
With the advent of digital cameras, there has been an explosion in the number of medical specialties using images to diagnose or document disease and guide interventions. In many specialties, these images are not added to the patient's electronic medical record and are not distributed so that other providers caring for the patient can view them. As hospitals begin to develop enterprise imaging strategies, they have found that there are multiple challenges preventing the implementation of systems to manage image capture, image upload, and image management. This HIMSS-SIIM white paper will describe the key workflow challenges related to enterprise imaging and offer suggestions for potential solutions to these challenges.
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Affiliation(s)
- Alexander J Towbin
- Department of Radiology, Cincinnati Children's Hospital, 3333 Burnet Avenue, MLC 5013, Cincinnati, OH, 45229, USA.
| | - Christopher J Roth
- Duke Health Technology Solutions, Hock Plaza, 2424 Erwin Road, Durham, NC, 27705, USA
- Department of Radiology, Duke University Hospital, 2301 Erwin Road, Box 3808, Durham, NC, 27710, USA
| | - Mark Bronkalla
- Merge Healthcare, an IBM Company, 900 Walnut Ridge Drive, Hartland, WI, 53029, USA
| | - Dawn Cram
- UHealth Information Technology, University of Miami, 1425 N.W. 10th Avenue, Miami, FL, 33136, USA
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Tesselaar E, Flejmer AM, Farnebo S, Dasu A. Changes in skin microcirculation during radiation therapy for breast cancer. Acta Oncol 2017; 56:1072-1080. [PMID: 28281359 DOI: 10.1080/0284186x.2017.1299220] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The majority of breast cancer patients who receive radiation treatment are affected by acute radiation-induced skin changes. The assessment of these changes is usually done by subjective methods, which complicates the comparison between different treatments or patient groups. This study investigates the feasibility of new robust methods for monitoring skin microcirculation to objectively assess and quantify acute skin reactions during radiation treatment. MATERIAL AND METHODS Laser Doppler flowmetry, laser speckle contrast imaging, and polarized light spectroscopy imaging were used to measure radiation-induced changes in microvascular perfusion and red blood cell concentration (RBC) in the skin of 15 patients undergoing adjuvant radiation therapy for breast cancer. Measurements were made before treatment, once a week during treatment, and directly after the last fraction. RESULTS In the treated breast, perfusion and RBC concentration were increased after 1-5 fractions (2.66-13.3 Gy) compared to baseline. The largest effects were seen in the areola and the medial area. No changes in perfusion and RBC concentration were seen in the untreated breast. In contrast, Radiation Therapy Oncology Group (RTOG) scores were increased only after 2 weeks of treatment, which demonstrates the potential of the proposed methods for early assessment of skin changes. Also, there was a moderate to good correlation between the perfusion (r = 0.52) and RBC concentration (r = 0.59) and the RTOG score given a week later. CONCLUSION We conclude that radiation-induced microvascular changes in the skin can be objectively measured using novel camera-based techniques before visual changes in the skin are apparent. Objective measurement of microvascular changes in the skin may be valuable in the comparison of skin reactions between different radiation treatments and possibly in predicting acute skin effects at an earlier stage.
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Affiliation(s)
- Erik Tesselaar
- Department of Radiation Physics and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Anna M. Flejmer
- Department of Oncology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Simon Farnebo
- Department of Hand and Plastic Surgery and Burns and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Alexandru Dasu
- Department of Radiation Physics and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- The Skandion Clinic, Uppsala, Sweden
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