mestrado integrado introdução à medicina i turma 6 6fmup0910@gmail.com 27-10-2009 professor...

Mestrado IntegradoIntrodução à Medicina I

Turma 66fmup0910@gmail.com

27-10-2009

ProfessorAltamiro Pereira

ARTIFICIAL INTELLIGENCE SYSTEMS FOR DIRECT PATIENT CARE IN

INTENSIVE CARE UNITS:A SYSTEMATIC REVIEW

2

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

AI: Definition

Medical artificial intelligence is primarily concerned with the construction of AI programs that perform diagnosis and make therapy recommendations. [1]

AI in medicine:

AI in medicine appeared as an answer to an evolving problem –the escalating amount of information that doctors have to deal with everyday.

Introduction

[1] Enrico Coiera ; Guide to Medical Informatics, the Internet and Telemedicine [Internet]; 1st Edition; London; Arnold; August 1997; Chapter 19, Introduction; [cited 2009 Oct 27]; Available from: http://www.openclinical.org/aiinmedicine.html

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ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Introduction

AI and ICU

• Intensive care medicine frequently involves making rapid decisions on the basis of a large and disparate array of information. [2]

• Since the technology of monitoring astronauts’ vital signs in space was transferred to the bedside in the 1960s, patient monitoring systems have become an indispensable part of critical care. [3] • Today, with more biosensors and computational power, these systems can simultaneously gather and display multiple physiological signals, derive clinically important parameters, and generate alerts to clinicians. [3]

[2] Jason H. T. Bates and Michael P. Young; Applying Fuzzy Logic to Medical Decision Making in theIntensive Care Unit; 2003 Apr[3] Ying Zhang, MEng Real-Time Development of Patient-Specific Alarm Algorithms; Proceedings of the 29th Annual International; Conference of the IEEE EMBS; Cité Internationale, Lyon, FranceAugust 23-26, 2007

4

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Introduction

Direct Patient Care

• Since trauma injuries have specific causes, all with established methods of treatment, fatal complications and long-term disabilities can be reduced by making less subjective and more accurate decisions in trauma units. [4]

• Critically-ill patients need continuous monitoring, which is an impractical, if not impossible, task for the caregivers to carry out solely in the ICU and other critical care settings. [3]

[3] Ying Zhang, MEng Real-Time Development of Patient-Specific Alarm Algorithms; Proceedings of the 29th Annual International; Conference of the IEEE EMBS; Cité Internationale, Lyon, FranceAugust 23-26, 2007[4]Soo-Yeon Ji, Rebecca Smith, Toan Huynh and Kayvan Najarian; A comparative analysis of multi-level computer-assisted decision making systems for traumatic injuries; 2009 Jan

5

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Introduction

Important concepts related to Artificiall Intelligence: [5]•Management information system (MIS)•Data stream.•Rule-based (expert) systems•Data mining•Neural networks•Machine learning•Case-based reasoning•Data visualization

[5] Hanson CW 3rd, Marshall BE; Artificial intelligence applications in the intensive care unit; Critical care medicine; 2001 Feb; 29 (2); 427-35

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Are artificial intelligence systems used

and useful when applied to direct patient

care in the intensive care unit when

compared to the traditional methods?

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Research question

7

To review the current applications of

artificial intelligence for direct

patient care in the intensive care

unit.

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Aim

8

•Determine if artificial intelligence systems are currently being used in intensive care units for direct patient care;

•Inspect the benefits and drawbacks of artificial intelligence systems for direct patient care compared to traditional methods of analysis;

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Specific objectives

9

•Expose the use of artificial intelligence systems as decision support mechanisms for direct patient care in intensive care units;

•Evaluate the acceptance of artificial intelligence systems by the health professionals.

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Specific objectives

10

 4-Interpretation of results and Report Writing.

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Methods

Study design: Systematic review    

1-A comprehensive, exhaustive search, in electronic databases, and inclusion of primary studies.

2-Quality assessment of included studies and data extraction (review, by two persons, of the title and the abstract or the article. Same process for the full article. A third opinion may be requested).

3-Synthesis of study results (SPSS and Review Manager).

11

Data collection:

•MEDLINE articles;

•Scopus articles;

•ISI Web of Knowledge articles.

•Additional direct search in critical care journals

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Methods

12

Search: Artificial Intelligence, since 2001. 30248 Articles

Professor

Altamiro PereiraTurma 6

6fmup0910@gmail.com

27-10-2009

Methods

("2001-01-01"[PDAT] : "3000"[PDAT]) AND (("artificial intelligence"[MeSH Terms] OR ("artificial"[All Fields] AND "intelligence"[All Fields]) OR "artificial intelligence"[All Fields]) OR AIs[All Fields] OR ("artificial intelligence"[MeSH Terms] OR ("artificial"[All Fields] AND "intelligence"[All Fields]) OR "artificial intelligence"[All Fields] OR ("computer"[All Fields] AND "reasoning"[All Fields]) OR "computer reasoning"[All Fields]) OR ("artificial intelligence"[MeSH Terms] OR ("artificial"[All Fields] AND "intelligence"[All Fields]) OR "artificial intelligence"[All Fields] OR ("machine"[All Fields] AND "intelligence"[All Fields]) OR "machine intelligence"[All Fields]) OR ("artificial intelligence"[MeSH Terms] OR ("artificial"[All Fields] AND "intelligence"[All Fields]) OR "artificial intelligence"[All Fields] OR ("machine"[All Fields] AND "learning"[All Fields]) OR "machine learning"[All Fields]) OR (("knowledge"[MeSH Terms] OR "knowledge"[All Fields]) AND Representation[All Fields]) OR ("artificial intelligence"[MeSH Terms] OR ("artificial"[All Fields] AND "intelligence"[All Fields]) OR "artificial intelligence"[All Fields] OR ("computer"[All Fields] AND "vision"[All Fields] AND "systems"[All Fields]) OR "computer vision systems"[All Fields]) OR ("artificial intelligence"[MeSH Terms] OR ("artificial"[All Fields] AND "intelligence"[All Fields]) OR "artificial intelligence"[All Fields] OR ("computer"[All Fields] AND "vision"[All Fields] AND "system"[All Fields]) OR "computer vision system"[All Fields]))

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Search: Intensive Care Unit, since 2001. 122153 Articles

Professor

Altamiro PereiraTurma 6

6fmup0910@gmail.com

27-10-2009

Methods

("2001-01-01"[PDAT] : "3000"[PDAT]) AND (("intensive care"[MeSH Terms] OR ("intensive"[All Fields] AND "care"[All Fields]) OR "intensive care"[All Fields]) OR ("intensive care units"[MeSH Terms] OR ("intensive"[All Fields] AND "care"[All Fields] AND "units"[All Fields]) OR "intensive care units"[All Fields]) OR ICU[All Fields] OR NICU[All Fields] OR PICU[All Fields] OR ("critical care"[MeSH Terms] OR ("critical"[All Fields] AND "care"[All Fields]) OR "critical care"[All Fields]) OR CC[All Fields])

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Search: Direct Patient Care, since 2001.688782 Articles.

Professor

Altamiro PereiraTurma 6

6fmup0910@gmail.com

27-10-2009

Methods

("01-01-2001"[PDAT] : "3000"[PDAT]) AND ((Direct[All Fields] AND ("patient care"[MeSH Terms] OR ("patient"[All Fields] AND "care"[All Fields]) OR "patient care"[All Fields])) OR DPC[All Fields] OR ("patient care"[MeSH Terms] OR ("patient"[All Fields] AND "care"[All Fields]) OR "patient care"[All Fields]))

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Search: Previous queries all together. Since 2001. 263 Articles

Professor

Altamiro PereiraTurma 6

6fmup0910@gmail.com

27-10-2009

Methods

963

356

44438

16

Inclusion criteria:

•Articles which refer AI monitoring techniques in ICU;•Articles which refer AI techniques for decision supporting in ICU;•Articles which refer AI alerting techniques in ICU.

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Methods

17

Exclusion criteria:

•Articles in which AI systems are used only as database;•Articles only with a theoretical approach to the subject, without a concrete study.

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Methods

18

Study variables:•Characteristics of the articles (year, author and country of publishing, etc…)

•Type of study (number of participants, duration, etc…)

•Domain of application (neurological, respiratory, cardiovascular, etc…)

•Area of Application (Monitoring, Alerting, Decision Supporting, etc..)

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Methods

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Statistical analysis: •Analysis of the study variables using the appropriate frequency measures;

•Possible associative analysis between factors and outcomes in the cases in which such aspects are included, resorting to adequate association measures.

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Methods

20

•Description of few systems that apply artificial intelligence in intensive care units;

•Reduced acceptance;

•Greater number of benefits when compared to the drawbacks.

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

Expected results

21

ProfessorAltamiro Pereira

Turma 66fmup0910@gmail.com

27-10-2009

References

[1] Enrico Coiera ; Guide to Medical Informatics, the Internet and Telemedicine [Internet]; 1st Edition; London; Arnold; August 1997; Chapter 19, Introduction; [cited 2009 Oct 27]; Available from: http://www.openclinical.org/aiinmedicine.html

[2] Jason H. T. Bates and Michael P. Young; Applying Fuzzy Logic to Medical Decision Making in theIntensive Care Unit; 2003 Apr

[3] Ying Zhang, MEng Real-Time Development of Patient-Specific Alarm Algorithms Proceedings of the 29th Annual InternationalConference of the IEEE EMBSCité Internationale, Lyon, FranceAugust 23-26, 2007

[4]Soo-Yeon Ji, Rebecca Smith, Toan Huynh and Kayvan Najarian; A comparative analysis of multi-level computer-assisted decisionmaking systems for traumatic injuries; 2009 Jan

[5] Hanson CW 3rd, Marshall BE; Artificial intelligence applications in the intensive care unit; Critical care medicine; 2001 Feb; 29 (2); 427-35