Addressing the Challenges and Barriers to the Integration of Machine Learning into Clinical Practice: An Innovative Method to Hybrid Human-Machine Intelligence

Advances in the application of human-machine collaboration in healthcare: insights from China

In the context of the technological revolution and the digital intelligence era, the contradiction between the rising incidence of diseases and the uneven distribution of quality medical resources is highlighted, and the diagnosis and prevention of diseases, and the prognosis and management of diseases are particularly important in the current society of aging population. "Human-machine collaboration" is based on an intelligent algorithmic system that utilizes the complementary strengths of humans and machines for data exchange, task allocation, decision making and collaborative work to provide more decision support. The traditional healthcare model is highly dependent on the unified management of hospitals, which further increases the burden on the healthcare system and often makes it difficult to formulate and implement personalized and precise rehabilitation programs for patients, which seriously affects their prognosis and quality of life, and increases the risk of re-admission to hospitals. In view of this, human-computer collaboration, an innovation-driven technology, is a groundbreaking solution to the outstanding healthcare issues of today. We use the subject words "Human-machine collaboration" OR "Human-Computer Interaction" OR "HCI" AND "chronic disease" OR "Health management" OR "Precision medicine "were searched for CNKI, Wanfang Data, VIP, CBM, PubMed, Web of science, Embase, Cochrane Library and other Chinese and English databases to identify all relevant studies and compare their results, and finally include 68 relevant literature articles, we identified the broad application of HCI in five main areas: disease screening and treatment, health management, medical education, traditional medicine, and the integration and processing of medical data. The aim is to review the concept of human-computer collaboration, its application in global healthcare environments, and the challenges it faces, with a view to continually driving innovation in healthcare models, optimizing the allocation of healthcare resources, and providing new paradigms for the development and application of innovative technologies in healthcare.

Machine Learning as a Diagnostic and Prognostic Tool for Predicting Thrombosis in Cancer Patients: A Systematic Review

Khorana score (KS) is an established risk assessment model for predicting cancer-associated thrombosis. However, it ignores several risk factors and has poor predictability in some cancer types. Machine learning (ML) is a novel technique used for the diagnosis and prognosis of several diseases, including cancer-associated thrombosis, when trained on specific diagnostic modalities. Consolidating the literature on the use of ML for the prediction of cancer-associated thrombosis is necessary to understand its diagnostic and prognostic abilities relative to KS. This systematic review aims to evaluate the current use and performance of ML algorithms to predict thrombosis in cancer patients. This study was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Databases Medline, EMBASE, Cochrane, and ClinicalTrials.gov, were searched from inception to September 15, 2023, for studies evaluating the use of ML models for the prediction of thrombosis in cancer patients. Search terms "machine learning," "artificial intelligence," "thrombosis," and "cancer" were used. Studies that examined adult cancer patients using any ML model were included. Two independent reviewers conducted study selection and data extraction. Three hundred citations were screened, of which 29 studies underwent a full-text review, and ultimately, 8 studies with 22,893 patients were included. Sample sizes ranged from 348 to 16,407 patients. Thrombosis was characterized as venous thromboembolism (n = 6) or peripherally inserted central catheter thrombosis (n = 2). The types of cancer included breast, gastric, colorectal, bladder, lung, esophageal, pancreatic, biliary, prostate, ovarian, genitourinary, head-neck, and sarcoma. All studies reported outcomes on the ML's predictive capacity. The extreme gradient boosting appears to be the best-performing model, and several models outperform KS in their respective datasets.

Prediction of the treatment response and local failure of patients with brain metastasis treated with stereotactic radiosurgery using machine learning: A systematic review and meta-analysis

BACKGROUND

Stereotactic radiosurgery (SRS) effectively treats brain metastases. It can provide local control, symptom relief, and improved survival rates, but it poses challenges in selecting optimal candidates, determining dose and fractionation, monitoring for toxicity, and integrating with other modalities. Practical tools to predict patient outcomes are also needed. Machine learning (ML) is currently used to predict treatment outcomes. We aim to investigate the accuracy of ML in predicting treatment response and local failure of brain metastasis treated with SRS.

METHODS

PubMed, Scopus, Web of Science (WoS), and Embase were searched until April 16th, which was repeated on October 17th, 2023 to find possible relevant papers. The study preparation adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The statistical analysis was performed by the MIDAS package of STATA v.17.

RESULTS

A total of 17 articles were reviewed, of which seven and eleven were related to the clinical use of ML in predicting local failure and treatment response. The ML algorithms showed sensitivity and specificity of 0.89 (95% CI: 0.84-0.93) and 0.87 (95% CI: 0.81-0.92) for predicting treatment response. The positive likelihood ratio was 7.1 (95% CI: 4.5-11.1), the negative likelihood ratio was 0.13 (95% CI: 0.08-0.19), and the diagnostic odds ratio was 56 (95% CI: 25-125). Moreover, the pooled estimates for sensitivity and specificity of ML algorithms for predicting local failure were 0.93 (95% CI: 0.76-0.98) and 0.80 (95% CI: 0.53-0.94). The positive likelihood ratio was 4.7 (95% CI: 1.6-14.0), the negative likelihood ratio was 0.09 (95% CI: 0.02-0.39), and the diagnostic odds ratio was 53 (95% CI: 5-606).

CONCLUSION

ML holds promise in predicting treatment response and local failure in brain metastasis patients receiving SRS. However, further studies and improvements in the treatment process can refine the models and effectively integrate them into clinical practice.

Strokecopilot: a literature-based clinical decision support system for acute ischemic stroke treatment

BACKGROUND

Acute ischemic stroke (AIS) is an immediate emergency whose management is becoming more and more personalized while facing a limited number of neurologists with high expertise. Clinical decision support systems (CDSS) are digital tools leveraging information and artificial intelligence technologies. Here, we present the Strokecopilot project, a CDSS for the management of the acute phase of AIS. It has been designed to support the evidence-based medicine reasoning of neurologists regarding the indications of intravenous thrombolysis (IVT) and endovascular treatments (ET).

METHODS

Reference populations were manually extracted from the field's main guidelines and randomized clinical trials (RCT). Their characteristics were harmonized in a computerized reference database. We developed a web application whose algorithm identifies the reference populations matching the patient's characteristics. It returns the latter's outcomes in a graphical user interface (GUI), whose design has been driven by real-world practices.

RESULTS

Strokecopilot has been released at www.digitalneurology.net . The reference database includes 25 reference populations from 2 guidelines and 15 RCTs. After a request, the reference populations matching the patient characteristics are displayed with a summary and a meta-analysis of their results. The status regarding IVT and ET indications are presented as "in guidelines", "in literature", or "outside literature references". The GUI is updated to provide several levels of explanation. Strokecopilot may be updated as the literature evolves by loading a new version of the reference populations' database.

CONCLUSION

Strokecopilot is a literature-based CDSS, developed to support neurologists in the management of the acute phase of AIS.

Deep Learning-Based IoT System for Remote Monitoring and Early Detection of Health Issues in Real-Time

With an aging population and increased chronic diseases, remote health monitoring has become critical to improving patient care and reducing healthcare costs. The Internet of Things (IoT) has recently drawn much interest as a potential remote health monitoring remedy. IoT-based systems can gather and analyze a wide range of physiological data, including blood oxygen levels, heart rates, body temperatures, and ECG signals, and then provide real-time feedback to medical professionals so they may take appropriate action. This paper proposes an IoT-based system for remote monitoring and early detection of health problems in home clinical settings. The system comprises three sensor types: MAX30100 for measuring blood oxygen level and heart rate; AD8232 ECG sensor module for ECG signal data; and MLX90614 non-contact infrared sensor for body temperature. The collected data is transmitted to a server using the MQTT protocol. A pre-trained deep learning model based on a convolutional neural network with an attention layer is used on the server to classify potential diseases. The system can detect five different categories of heartbeats: Normal Beat, Supraventricular premature beat, Premature ventricular contraction, Fusion of ventricular, and Unclassifiable beat from ECG sensor data and fever or non-fever from body temperature. Furthermore, the system provides a report on the patient's heart rate and oxygen level, indicating whether they are within normal ranges or not. The system automatically connects the user to the nearest doctor for further diagnosis if any critical abnormalities are detected.