systematic review and meta-analysis
AI in Oncology: Transforming Cancer Detection through Machine Learning and Deep Learning Applications
Aftab, Muhammad, Mehmood, Faisal, Zhang, Chengjuan, Nadeem, Alishba, Dong, Zigang, Jiang, Yanan, Liu, Kangdongs
Artificial intelligence (AI) has potential to revolutionize the field of oncology by enhancing the precision of cancer diagnosis, optimizing treatment strategies, and personalizing therapies for a variety of cancers. This review examines the limitations of conventional diagnostic techniques and explores the transformative role of AI in diagnosing and treating cancers such as lung, breast, colorectal, liver, stomach, esophageal, cervical, thyroid, prostate, and skin cancers. The primary objective of this paper is to highlight the significant advancements that AI algorithms have brought to oncology within the medical industry. By enabling early cancer detection, improving diagnostic accuracy, and facilitating targeted treatment delivery, AI contributes to substantial improvements in patient outcomes. The integration of AI in medical imaging, genomic analysis, and pathology enhances diagnostic precision and introduces a novel, less invasive approach to cancer screening. This not only boosts the effectiveness of medical facilities but also reduces operational costs. The study delves into the application of AI in radiomics for detailed cancer characterization, predictive analytics for identifying associated risks, and the development of algorithm-driven robots for immediate diagnosis. Furthermore, it investigates the impact of AI on addressing healthcare challenges, particularly in underserved and remote regions. The overarching goal of this platform is to support the development of expert recommendations and to provide universal, efficient diagnostic procedures. By reviewing existing research and clinical studies, this paper underscores the pivotal role of AI in improving the overall cancer care system. It emphasizes how AI-enabled systems can enhance clinical decision-making and expand treatment options, thereby underscoring the importance of AI in advancing precision oncology
Accelerating Clinical Evidence Synthesis with Large Language Models
Wang, Zifeng, Cao, Lang, Danek, Benjamin, Zhang, Yichi, Jin, Qiao, Lu, Zhiyong, Sun, Jimeng
Automatic medical discovery by AI is a dream of many. One step toward that goal is to create an AI model to understand clinical studies and synthesize clinical evidence from the literature. Clinical evidence synthesis currently relies on systematic reviews of clinical trials and retrospective analyses from medical literature. However, the rapid expansion of publications presents challenges in efficiently identifying, summarizing, and updating evidence. We introduce TrialMind, a generative AI-based pipeline for conducting medical systematic reviews, encompassing study search, screening, and data extraction phases. We utilize large language models (LLMs) to drive each pipeline component while incorporating human expert oversight to minimize errors. To facilitate evaluation, we also create a benchmark dataset TrialReviewBench, a custom dataset with 870 annotated clinical studies from 25 meta-analysis papers across various medical treatments. Our results demonstrate that TrialMind significantly improves the literature review process, achieving high recall rates (0.897-1.000) in study searching from over 20 million PubMed studies and outperforming traditional language model embeddings-based methods in screening (Recall@20 of 0.227-0.246 vs. 0.000-0.102). Furthermore, our approach surpasses direct GPT-4 performance in result extraction, with accuracy ranging from 0.65 to 0.84. We also support clinical evidence synthesis in forest plots, as validated by eight human annotators who preferred TrialMind over the GPT-4 baseline with a winning rate of 62.5%-100% across the involved reviews. Our findings suggest that an LLM-based clinical evidence synthesis approach, such as TrialMind, can enable reliable and high-quality clinical evidence synthesis to improve clinical research efficiency.
Feasibility of Identifying Factors Related to Alzheimer's Disease and Related Dementia in Real-World Data
Chen, Aokun, Li, Qian, Huang, Yu, Li, Yongqiu, Chuang, Yu-neng, Hu, Xia, Guo, Serena, Wu, Yonghui, Guo, Yi, Bian, Jiang
A comprehensive view of factors associated with AD/ADRD will significantly aid in studies to develop new treatments for AD/ADRD and identify high-risk populations and patients for prevention efforts. In our study, we summarized the risk factors for AD/ADRD by reviewing existing meta-analyses and review articles on risk and preventive factors for AD/ADRD. In total, we extracted 477 risk factors in 10 categories from 537 studies. We constructed an interactive knowledge map to disseminate our study results. Most of the risk factors are accessible from structured Electronic Health Records (EHRs), and clinical narratives show promise as information sources. However, evaluating genomic risk factors using RWD remains a challenge, as genetic testing for AD/ADRD is still not a common practice and is poorly documented in both structured and unstructured EHRs. Considering the constantly evolving research on AD/ADRD risk factors, literature mining via NLP methods offers a solution to automatically update our knowledge map.
Evaluation of ChatGPT-Generated Medical Responses: A Systematic Review and Meta-Analysis
Wei, Qiuhong, Yao, Zhengxiong, Cui, Ying, Wei, Bo, Jin, Zhezhen, Xu, Ximing
Large language models such as ChatGPT are increasingly explored in medical domains. However, the absence of standard guidelines for performance evaluation has led to methodological inconsistencies. This study aims to summarize the available evidence on evaluating ChatGPT's performance in medicine and provide direction for future research. We searched ten medical literature databases on June 15, 2023, using the keyword "ChatGPT". A total of 3520 articles were identified, of which 60 were reviewed and summarized in this paper and 17 were included in the meta-analysis. The analysis showed that ChatGPT displayed an overall integrated accuracy of 56% (95% CI: 51%-60%, I2 = 87%) in addressing medical queries. However, the studies varied in question resource, question-asking process, and evaluation metrics. Moreover, many studies failed to report methodological details, including the version of ChatGPT and whether each question was used independently or repeatedly. Our findings revealed that although ChatGPT demonstrated considerable potential for application in healthcare, the heterogeneity of the studies and insufficient reporting may affect the reliability of these results. Further well-designed studies with comprehensive and transparent reporting are needed to evaluate ChatGPT's performance in medicine.
Artificial Intelligence in Fracture Detection: A Systematic Review and Meta-Analysis
Patients with fractures are a common emergency presentation and may be misdiagnosed at radiologic imaging. An increasing number of studies apply artificial intelligence (AI) techniques to fracture detection as an adjunct to clinician diagnosis. To perform a systematic review and meta-analysis comparing the diagnostic performance in fracture detection between AI and clinicians in peer-reviewed publications and the gray literature (ie, articles published on preprint repositories). A search of multiple electronic databases between January 2018 and July 2020 (updated June 2021) was performed that included any primary research studies that developed and/or validated AI for the purposes of fracture detection at any imaging modality and excluded studies that evaluated image segmentation algorithms. Meta-analysis with a hierarchical model to calculate pooled sensitivity and specificity was used.
A causal learning framework for the analysis and interpretation of COVID-19 clinical data
Ferrari, Elisa, Gargani, Luna, Barbieri, Greta, Ghiadoni, Lorenzo, Faita, Francesco, Bacciu, Davide
We present a workflow for clinical data analysis that relies on Bayesian Structure Learning (BSL), an unsupervised learning approach, robust to noise and biases, that allows to incorporate prior medical knowledge into the learning process and that provides explainable results in the form of a graph showing the causal connections among the analyzed features. The workflow consists in a multi-step approach that goes from identifying the main causes of patient's outcome through BSL, to the realization of a tool suitable for clinical practice, based on a Binary Decision Tree (BDT), to recognize patients at high-risk with information available already at hospital admission time. We evaluate our approach on a feature-rich COVID-19 dataset, showing that the proposed framework provides a schematic overview of the multi-factorial processes that jointly contribute to the outcome. We discuss how these computational findings are confirmed by current understanding of the COVID-19 pathogenesis. Further, our approach yields to a highly interpretable tool correctly predicting the outcome of 85% of subjects based exclusively on 3 features: age, a previous history of chronic obstructive pulmonary disease and the PaO2/FiO2 ratio at the time of arrival to the hospital.
An open-source machine learning framework to carry out systematic reviews
When scientists carry out research on a given topic, they often start by reviewing previous study findings. Conducting systematic literature reviews or meta-analyses can be very challenging and time consuming, as there are often huge amounts of research focusing on different topics, which may not always be relevant to a researcher's work. Researchers at Utrecht University have recently developed a machine learning framework that could significantly speed up this process, by automatically browsing through numerous past studies and compiling high quality literature reviews. This framework, called ASReview, could prove particularly useful for conducting research during the COVID-19 pandemic. "Researchers and experts face a major challenge to stay up-to-date with the latest developments in their field nowadays," Jonathan de Bruin, lead engineer involved in the study, told TechXplore.
High pooled performance of convolutional neural networks in computer-aided diagnosis of GI ulcers and/or hemorrhage on wireless capsule endoscopy images: a systematic review and meta-analysis
Diagnosis of gastrointestinal (GI) ulcers and/or hemorrhage by wireless capsule endoscopy (WCE) is limited by the physician-dependent, tedious, time-consuming process of image and/ or video classification. Computer-aided diagnosis (CAD) by convolutional neural networks (CNN) based machine learning may help reduce this burden. Our aim was to conduct a meta-analysis and appraise the reported data.
Machine learning for the prediction of sepsis: a systematic review and meta-analysis of diagnostic test accuracy
Early clinical recognition of sepsis can be challenging. With the advancement of machine learning, promising real-time models to predict sepsis have emerged. We assessed their performance by carrying out a systematic review and meta-analysis. Studies targeting sepsis, severe sepsis or septic shock in any hospital setting were eligible for inclusion. The index test was any supervised machine learning model for real-time prediction of these conditions.
Distilling Information from a Flood: A Possibility for the Use of Meta-Analysis and Systematic Review in Machine Learning Research
Henderson, Peter, Brunskill, Emma
The current flood of information in all areas of machine learning research, from computer vision to reinforcement learning, has made it difficult to make aggregate scientific inferences. It can be challenging to distill a myriad of similar papers into a set of useful principles, to determine which new methodologies to use for a particular application, and to be confident that one has compared against all relevant related work when developing new ideas. However, such a rapidly growing body of research literature is a problem that other fields have already faced - in particular, medicine and epidemiology. In those fields, systematic reviews and meta-analyses have been used exactly for dealing with these issues and it is not uncommon for entire journals to be dedicated to such analyses. Here, we suggest the field of machine learning might similarly benefit from meta-analysis and systematic review, and we encourage further discussion and development along this direction.