Globalization and environment, the most frequent underlying drivers, should be targeted for interventions to prevent such events.
Globalization and environment, the most frequent underlying drivers, should be targeted for interventions to prevent such events.
ObjectivesThis work aims at uncovering challenges in biomedical knowledge representation research by providing an understanding of what was historically called "medical concept representation" and used as the name for a working group of the International Medical Informatics Association.MethodsBibliometrics, text mining, and a social media survey compare the research done in this area between two periods, before and after 2000.ResultsBoth the opinion of socially active groups of researchers and the interpretation of bibliometric data since 1988 suggest that the focus of research has moved from "medical concept representation" to "medical ontologies".ConclusionsIt remains debatable whether the observed change amounts to a paradigm shift or whether it simply reflects changes in naming, following the natural evolution of ontology research and engineering activities in the 1990s. The availability of powerful tools to handle ontologies devoted to certain areas of biomedicine has not resulted in a large-scale breakthrough beyond advances in basic research.
Introduction: Artificial intelligence (AI) is widespread in many areas, including medicine. However, it is unclear what exactly AI encompasses. This paper aims to provide an improved understanding of medical AI and its constituent fields, and their interplay with knowledge representation (KR). Methods: We followed a Wittgensteinian approach (“meaning by usage”) applied to content metadata labels, using the Medical Subject Headings (MeSH) thesaurus to classify the field. To understand and characterize medical AI and the role of KR, we analyzed: (1) the proportion of papers in MEDLINE related to KR and various AI fields; (2) the interplay among KR and AI fields and overlaps among the AI fields; (3) interconnectedness of fields; and (4) phrase frequency and collocation based on a corpus of abstracts. Results: Data from over eighty thousand papers showed a steep, six-fold surge in the last 30 years. This growth happened in an escalating and cascading way. A corpus of 246,308 total words containing 21,842 unique words showed several hundred occurrences of notions such as robotics, fuzzy logic, neural networks, machine learning and expert systems in the phrase frequency analysis. Collocation analysis shows that fuzzy logic seems to be the most often collocated notion. Neural networks and machine learning are also used in the conceptual neighborhood of KR. Robotics is more isolated. Conclusions: Authors note an escalation of published AI studies in medicine. Knowledge representation is one of the smaller areas, but also the most interconnected, and provides a common cognitive layer for other areas.
BackgroundArtificial intelligence (AI) has attracted much attention because of its enormous potential in healthcare, but uptake has been slow. There are substantial barriers that challenge health technology assessment (HTA) professionals to use AI-generated evidence for decision-making from large real-world databases (e.g., based on claims data). As part of the European Commission-funded HTx H2020 (Next Generation Health Technology Assessment) project, we aimed to put forward recommendations to support healthcare decision-makers in integrating AI into the HTA processes. The barriers, addressed by the paper, are particularly focusing on Central and Eastern European (CEE) countries, where the implementation of HTA and access to health databases lag behind Western European countries.MethodsWe constructed a survey to rank the barriers to using AI for HTA purposes, completed by respondents from CEE jurisdictions with expertise in HTA. Using the results, two members of the HTx consortium from CEE developed recommendations on the most critical barriers. Then these recommendations were discussed in a workshop by a wider group of experts, including HTA and reimbursement decision-makers from both CEE countries and Western European countries, and summarized in a consensus report.ResultsRecommendations have been developed to address the top 15 barriers in areas of (1) human factor-related barriers, focusing on educating HTA doers and users, establishing collaborations and best practice sharing; (2) regulatory and policy-related barriers, proposing increasing awareness and political commitment and improving the management of sensitive information for AI use; (3) data-related barriers, suggesting enhancing standardization and collaboration with data networks, managing missing and unstructured data, using analytical and statistical approaches to address bias, using quality assessment tools and quality standards, improving reporting, and developing better conditions for the use of data; and (4) technological barriers, suggesting sustainable development of AI infrastructure.ConclusionIn the field of HTA, the great potential of AI to support evidence generation and evaluation has not yet been sufficiently explored and realized. Raising awareness of the intended and unintended consequences of AI-based methods and encouraging political commitment from policymakers is necessary to upgrade the regulatory and infrastructural environment and knowledge base required to integrate AI into HTA-based decision-making processes better.
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