Pediatric Predictive Artificial Intelligence Implemented in Clinical Practice from 2010 to 2021: A Systematic Review.

Journal: Applied clinical informatics
Published Date:

Abstract

To review pediatric artificial intelligence (AI) implementation studies from 2010 to 2021 and analyze reported performance measures.We searched PubMed/Medline, Embase CINHAL, Cochrane Library CENTRAL, IEEE, and Web of Science with controlled vocabulary. Inclusion criteria: AI intervention in a pediatric clinical setting that learns from data (i.e., data-driven, as opposed to rule-based) and takes actions to make patient-specific recommendations; published between 01/2010 and 10/2021; must have agency (AI must provide guidance that affects clinical care, not merely running in the background). We extracted study characteristics, target users, implementation setting, time span, and performance measures.Of 126 articles reviewed as full text, 17 met inclusion criteria. Eight studies (47%) reported both clinical outcomes and process measures, six (35%) reported only process measures and two (12%) reported only clinical outcomes. Five studies (30%) reported no difference in clinical outcomes with AI, four (24%) reported improvement in clinical outcomes compared with controls, two (12%) reported positive effects on clinical outcomes with use of AI but had no formal comparison or controls, and one (6%) reported poor clinical outcomes with AI. Twelve studies (71%) reported improvement in process measures, while two (12%) reported no improvement. Five (30%) studies reported on at least 1 human performance measure.While there are many published pediatric AI models, the number of AI implementations is minimal with no standardized reporting of outcomes, care processes, or human performance measures. More comprehensive evaluations will help elucidate mechanisms of impact.

Authors

  • Swaminathan Kandaswamy
    Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
  • Lindsey A Knake
    University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA. lindsey-knake@uiowa.edu.
  • Adam C Dziorny
    Department of Pediatrics, University of Rochester, Rochester, NY.
  • Sean M Hernandez
    Primary Care, Miami Veteran's Affairs, Miami, Florida, United States.
  • Allison B McCoy
    Vanderbilt University Medical Center, Nashville, TN.
  • Lauren M Hess
    Pediatric Hospital Medicine, Texas Children's Hospital, Houston, Texas, United States.
  • Evan Orenstein
    Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States.
  • Mia S White
    Woodruff Health Sciences Center Library, Emory University, Atlanta, Georgia, United States.
  • Eric S Kirkendall
    Department of Pediatrics, Wake Forest University School of Medicine, Center for Healthcare Innovation, Winston-Salem, North Carolina, United States.
  • Matthew J Molloy
    Department of Pediatrics, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio, United States.
  • Philip A Hagedorn
    Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  • Naveen Muthu
    Department of Biomedical Informatics, CHOP.
  • Avinash Murugan
    Yale New Haven Hospital, New Haven, CT, United States.
  • Jonathan M Beus
    Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States.
  • Mark Mai
    Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States.
  • Brooke Luo
    Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.
  • Juan D Chaparro
    University of California San Diego, La Jolla, CA.