Evaluation and accurate diagnoses of pediatric diseases using artificial intelligence.

Journal: Nature medicine
Published Date: Feb 11, 2019

Abstract

Artificial intelligence (AI)-based methods have emerged as powerful tools to transform medical care. Although machine learning classifiers (MLCs) have already demonstrated strong performance in image-based diagnoses, analysis of diverse and massive electronic health record (EHR) data remains challenging. Here, we show that MLCs can query EHRs in a manner similar to the hypothetico-deductive reasoning used by physicians and unearth associations that previous statistical methods have not found. Our model applies an automated natural language processing system using deep learning techniques to extract clinically relevant information from EHRs. In total, 101.6 million data points from 1,362,559 pediatric patient visits presenting to a major referral center were analyzed to train and validate the framework. Our model demonstrates high diagnostic accuracy across multiple organ systems and is comparable to experienced pediatricians in diagnosing common childhood diseases. Our study provides a proof of concept for implementing an AI-based system as a means to aid physicians in tackling large amounts of data, augmenting diagnostic evaluations, and to provide clinical decision support in cases of diagnostic uncertainty or complexity. Although this impact may be most evident in areas where healthcare providers are in relative shortage, the benefits of such an AI system are likely to be universal.

Authors

  • Huiying Liang
    Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Brian Y Tsui
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Hao Ni
    Hangzhou YITU Healthcare Technology Co. Ltd, Hangzhou, China.
  • Carolina C S Valentim
    Shiley Eye Institute, Institute for Engineering in Medicine, Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
  • Sally L Baxter
    Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla.
  • Guangjian Liu
    Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Wenjia Cai
    Shiley Eye Institute, Institute for Engineering in Medicine, Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
  • Daniel S Kermany
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510005 Guangzhou, China; Shiley Eye Institute, Institute for Engineering in Medicine, Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
  • Xin Sun
    Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA USA.
  • Jiancong Chen
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Liya He
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Jie Zhu
    Department of Digestive Diseases, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.
  • Pin Tian
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Hua Shao
    Department of Vascular Surgery, Dalian University Affiliated Xinhua Hospital, Dalian 116021, Liaoning Province, China.
  • Lianghong Zheng
    YouHealth AI, 510005 Guangzhou, China.
  • Rui Hou
    Guangzhou KangRui Biological Pharmaceutical Technology Company, 510005 Guangzhou, China.
  • Sierra Hewett
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510005 Guangzhou, China; Shiley Eye Institute, Institute for Engineering in Medicine, Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
  • Gen Li
    Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, 200072, P.R.China.
  • Ping Liang
    Department of Pharmacy, The Fourth Hospital of Hebei Medical University Shijiazhuang 050000, Hebei, China.
  • Xuan Zang
    Hangzhou YITU Healthcare Technology Co. Ltd, Hangzhou, China.
  • Zhiqi Zhang
    Hangzhou YITU Healthcare Technology Co. Ltd, Hangzhou, China.
  • Liyan Pan
    Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Huimin Cai
    Guangzhou Kangrui Co. Ltd, Guangzhou, China.
  • Rujuan Ling
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Shuhua Li
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Yongwang Cui
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Shusheng Tang
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Hong Ye
    Department of Radiation Oncology, Beaumont Health, Royal Oak, Michigan.
  • Xiaoyan Huang
    Department of Cardiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang 310015, P.R. China.
  • Waner He
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Wenqing Liang
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Qing Zhang
    Department of Respiratory Medicine, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.
  • Jianmin Jiang
    School of Computer Science and Software Engineering, Shenzhen University, Shenzhen 518060, China.
  • Wei Yu
    Quality Control Department, Jiangxi Provincial Blood Center Nanchang 330052, Jiangxi, China.
  • Jianqun Gao
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Wanxing Ou
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Yingmin Deng
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Qiaozhen Hou
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Bei Wang
    University of Utah, USA.
  • Cuichan Yao
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Yan Liang
    Department of Chemistry and Biochemistry, The University of Arizona, Tucson, AZ, 85721, United States.
  • Shu Zhang
    State University of New York, Department of Radiology, Stony Brook, New York, United States.
  • Yaou Duan
    Shiley Eye Institute, Institute for Engineering in Medicine, Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
  • Runze Zhang
    Shiley Eye Institute, Institute for Engineering in Medicine, Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
  • Sarah Gibson
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Charlotte L Zhang
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510005 Guangzhou, China; Shiley Eye Institute, Institute for Engineering in Medicine, Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
  • Oulan Li
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510005 Guangzhou, China; Shiley Eye Institute, Institute for Engineering in Medicine, Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
  • Edward D Zhang
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510005 Guangzhou, China; Shiley Eye Institute, Institute for Engineering in Medicine, Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
  • Gabriel Karin
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Nathan Nguyen
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Xiaokang Wu
    Molecular Medicine Research Center, State Key Laboratory of Biotherapy, The National Clinical Research Center of Senile Disease, West China Hospital, Sichuan University, Chengdu, China.
  • Cindy Wen
    Shiley Eye Institute, Institute for Engineering in Medicine, Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
  • Jie Xu
    Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang Province 310000, China.
  • Wenqin Xu
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Bochu Wang
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Winston Wang
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Jing Li
    Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.
  • Bianca Pizzato
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Caroline Bao
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Daoman Xiang
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Wanting He
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Suiqin He
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Yugui Zhou
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
  • Weldon Haw
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Michael Goldbaum
    Shiley Eye Institute, Institute for Engineering in Medicine, Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
  • Adriana Tremoulet
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Chun-Nan Hsu
    University of California San Diego, La Jolla, CA.
  • Hannah Carter
    Institute for Genomic Medicine, Institute of Engineering in Medicine, and Shiley Eye Institute, University of California, San Diego, La Jolla, CA, USA.
  • Long Zhu
    Hangzhou YITU Healthcare Technology Co. Ltd, Hangzhou, China.
  • Kang Zhang
    Xifeng District People's Hospital, Qingyang, China.
  • Huimin Xia
    Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China. xia-huimin@foxmail.com.

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