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Mestrado Integrado Introdução à Medicina I

ARTIFICIAL INTELLIGENCE SYSTEMS FOR DIRECT PATIENT CARE IN INTENSIVE CARE UNITS: A SYSTEMATIC REVIEW. Mestrado Integrado Introdução à Medicina I. Turma 6 6fmup0910@gmail.com. Professor Altamiro Pereira. 27-10-2009. Introduction. AI: Definition.

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Mestrado Integrado Introdução à Medicina I

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  1. ARTIFICIAL INTELLIGENCE SYSTEMS FOR DIRECT PATIENT CARE IN INTENSIVE CARE UNITS:A SYSTEMATIC REVIEW Mestrado Integrado Introdução à Medicina I Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  2. Introduction 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. [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 Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  3. 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 the Intensive 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, France August 23-26, 2007 Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  4. 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, France August 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 Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  5. Introduction • Important concepts related to Artificiall Intelligence: [5] • Managementinformation 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 Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  6. Are artificial intelligence systems used and useful when applied to direct patient care in the intensive care unit when compared to the traditional methods? Research question Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  7. To review the current applications of artificial intelligence for direct patient care in the intensive care unit. Aim Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  8. Specific objectives • 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; Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  9. Specific objectives • 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. Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  10. 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). 4-Interpretation of results and Report Writing. Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  11. Methods • Data collection: • MEDLINE articles; • Scopus articles; • ISI Web of Knowledge articles. • Additional direct search in critical care journals Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  12. Methods Search: Artificial Intelligence, since 2001. 30248 Articles ("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])) Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  13. Methods Search: Intensive Care Unit, since 2001. 122153 Articles ("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]) Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  14. Methods Search: Direct Patient Care, since 2001.688782 Articles. ("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])) Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  15. Methods Search: Previous queries all together. Since 2001. 263 Articles 44438 356 963 Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  16. Methods 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. Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  17. Methods 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. Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  18. Methods • 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..) Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  19. Methods • 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. Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  20. Expected results • Description of few systems that apply artificial intelligence in intensive care units; • Reduced acceptance; • Greater number of benefits when compared to the drawbacks. Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

  21. 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 the Intensive 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, France August 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] Hanson CW 3rd, Marshall BE; Artificial intelligence applications in the intensive care unit; Critical care medicine; 2001 Feb; 29 (2); 427-35 Turma 6 6fmup0910@gmail.com Professor Altamiro Pereira 27-10-2009

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