What are the primary causes of the low adoption rate for AI-based Clinical Decision Support Systems (CDSS) in healthcare?5 answersThe low adoption rate of AI-based Clinical Decision Support Systems (CDSS) in healthcare can be attributed to various factors identified in the research. These include issues such as inefficient or error-prone processes resulting from technically successful implementations, fear of loss of autonomy and difficulties in integrating AI into clinical workflows, and the need for further understanding of specificity, false positive rates, and the impact on patients with non-cancer diseases. Additionally, challenges related to the usefulness and trust in AI-generated insights, as well as clinical workflow integration obstacles, contribute to the low adoption rates of AI-supported CDS. Furthermore, conflicting goals and requirements between developers and clinicians regarding Explainable Artificial Intelligence (XAI) solutions also play a role in hindering the adoption of AI/ML technologies in healthcare.
What is the impact of recent AI-driven decision support tools on clinical decision-making?5 answersRecent AI-driven decision support tools have shown significant impacts on clinical decision-making. These tools have the potential to increase patient autonomy, improve the accuracy of predictions, and support surrogate decision-making, ultimately enhancing beneficence in healthcare. Implementation of AI tools has led to an increase in structured orders and appropriateness scoring, indicating a positive shift in clinical practices. Furthermore, AI-based solutions have been developed to identify clinical factors associated with relapse and survival in cancer patients, aiding in the development of prognostic models for personalized care. In oncology, AI frameworks like ARCliDS have been designed to optimize decision-making by recommending daily dosage adjustments to maximize treatment outcomes and minimize side effects, showcasing the potential of AI in dynamic treatment regimes.
What is clinical decision support system?4 answersClinical decision support systems (CDSS) are computer-based tools that provide clinicians, staff, patients, or other individuals with knowledge and person-specific information to enhance health and healthcare. CDSS includes various tools such as computerized alerts and reminders, clinical guidelines, order sets, patient data reports, diagnostic support, and reference information. These systems are designed to assist medical professionals in making accurate and informed decisions by analyzing medical data and providing recommendations for diagnosis, treatment protocols, and prognosis. CDSS can use different approaches, including rules, ontologies, probabilistic models, machine learning, and deep learning techniques, to represent and infer medical knowledge. They aim to improve decision-making in the clinical workflow, reduce errors, and enhance patient outcomes. The effectiveness of CDSS is being studied through epidemiological research to provide clinical evidence for their use in medical practice.
What are the challenges to implementing AI in healthcare?4 answersThe challenges to implementing AI in healthcare include ethical considerations such as transparency, bias, privacy, safety, responsibility, justice, and autonomy. Other challenges include data privacy, regulatory compliance, and the need for appropriate ethical and regulatory frameworks. Additionally, there are challenges related to clinical safety, bias and discrimination, transparency and interpretability, data privacy, integration with existing health systems, and impacts on the healthcare workforce. The process of digitalization and implementation of AI in healthcare also raises technical, ethical, and legal questions that need to be better defined. Harmonized rules on artificial intelligence, privacy and data protection, data quality and management, and the development of regulatory frameworks are crucial for the successful implementation of AI in healthcare.
How has artificial intelligence or machine learning been used for clinical decision support?4 answersArtificial intelligence (AI) and machine learning (ML) have been used for clinical decision support in various ways. One application is the development of AI-based algorithms that can assist in the diagnosis and surveillance of infectious diseases such as pertussis or RSV infection in children based on common symptoms and laboratory tests. Another use is the creation of AI-based optimal decision-making frameworks to assist oncologists in dynamic treatment regimes (DTR) in oncology. These frameworks utilize advanced machine learning analytics and information-rich dense multi-omics data to overcome challenges in objective decision-making. Additionally, AI has been employed in the development of clinical decision support systems for acute ischemic stroke. These systems aim to directly correlate patient characteristics to outcomes using AI techniques, providing decision support to stroke clinicians. Overall, AI and ML have shown promise in improving clinical decision-making by leveraging data and algorithms to support diagnosis, treatment, and surveillance in various healthcare contexts.
What is the impact of clinical decision support systems on the quality of healthcare services?5 answersClinical decision support systems (CDSSs) have the potential to improve the quality of healthcare services. CDSSs can make contextually relevant predictions, contribute to more efficient and safe health systems, and improve diagnosis and treatment. However, there is a lack of substantial evidence for the thorough benefit of CDSSs, and their general frameworks and acceptance need to be further developed. The use of electronic medical records (EMRs) in CDSSs can accumulate qualitative medical data and reduce medical errors, but technical maturity and completeness of CDSSs still need improvement. Implementing a fully integrated electronic medical record system with clinical decision support (CDS) systems has shown positive impacts on healthcare services, such as increased uptake of immunizations and screening tests, and earlier diagnoses of breast and colon cancer. Ensuring the quality of CDSSs through evaluation and measurement can improve their acceptance and adoption by healthcare professionals.