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Randomized controlled trials of artificial intelligence in clinical practice: A systematic review (Preprint)

2022·0 ZitationenOpen Access
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6

Autoren

2022

Jahr

Abstract

<sec> <title>BACKGROUND</title> The number of artificial intelligence (AI) studies in medicine has exponentially increased recently. However, there is no clear quantification of clinical benefit when AI-assisted tools are implemented in patient care. </sec> <sec> <title>OBJECTIVE</title> We aim to systematically review all published randomized controlled trials (RCTs) of AI-assisted tools to characterize their performance in clinical practice. </sec> <sec> <title>METHODS</title> CINAHL, Cochrane Central, Embase, Medline and PubMed were searched to identify relevant RCTs comparing the performance of AI-assisted tool against conventional clinical management without AI-assistance published up to July 2021. We evaluated the primary endpoints of each study to determine which were clinically relevant. </sec> <sec> <title>RESULTS</title> Among 11,839 articles searched, only 38 RCTs identified were included. These RCTs were conducted in a roughly equal distribution from North America, Europe, and Asia. AI-assisted tools were implemented in 13 different clinical specialties. Most RCTs were published in the field of Gastroenterology, with 15 studies on AI-assisted endoscopy. The majority of RCTs studied image-based AI-assisted tools, and a minority of RCTs studied AI-assisted tools that drew from tabular patient. In 29 out of 38 RCTs, AI-assisted interventions outperformed usual clinical care, and clinically relevant outcomes improved with AI assisted intervention in 21 out of 29 studies. Small sample size and single-centre design limit the generalizability of these studies. </sec> <sec> <title>CONCLUSIONS</title> There is growing evidence supporting the implementation of AI-assisted tool in daily clinical practice, yet the number of available RCTs is limited and heterogeneous. Future studies are needed to quantify the benefit of AI-assisted tools in clinical practice. </sec> <sec> <title>CLINICALTRIAL</title> This study was registered on PROSPERO (ID: CRD42021286539). </sec>

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