Implemented machine learning tools to inform decision-making for patient care in hospital settings: a scoping review

Abstract

ObjectivesTo identify ML tools in hospital settings and how they were implemented to inform decision-making for patient care through a scoping review. We investigated the following research questions: What ML interventions have been used to inform decision-making for patient care in hospital settings? What strategies have been used to implement these ML interventions?DesignA scoping review was undertaken. MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews (CDSR) were searched from 2009 until June 2021. Two reviewers screened titles and abstracts, full-text articles, and charted data independently. Conflicts were resolved by another reviewer. Data were summarised descriptively using simple content analysis.SettingHospital setting.ParticipantAny type of clinician caring for any type of patient.InterventionMachine learning tools used by clinicians to inform decision-making for patient care, such as AI-based computerised decision support systems or “‘model-based’” decision support systems.Primary and secondary outcome measuresPatient and study characteristics, as well as intervention characteristics including the type of machine learning tool, implementation strategies, target population. Equity issues were examined with PROGRESS-PLUS criteria.ResultsAfter screening 17 386 citations and 3474 full-text articles, 20 unique studies and 1 companion report were included. The included articles totalled 82 656 patients and 915 clinicians. Seven studies reported gender and four studies reported PROGRESS-PLUS criteria (race, health insurance, rural/urban). Common implementation strategies for the tools were clinician reminders that integrated ML predictions (44.4%), facilitated relay of clinical information (17.8%) and staff education (15.6%). Common barriers to successful implementation of ML tools were time (11.1%) and reliability (11.1%), and common facilitators were time/efficiency (13.6%) and perceived usefulness (13.6%).ConclusionsWe found limited evidence related to the implementation of ML tools to assist clinicians with patient healthcare decisions in hospital settings. Future research should examine other approaches to integrating ML into hospital clinician decisions related to patient care, and report on PROGRESS-PLUS items.FundingCanadian Institutes of Health Research (CIHR) Foundation grant awarded to SES and the CIHR Strategy for Patient Oriented-Research Initiative (GSR-154442).Scoping review registrationhttps://osf.io/e2mna.

Artificial Intelligence and Decision-Making in Healthcare: A Thematic Analysis of a Systematic Review of Reviews

“…Meanwhile, the moderate number of final articles reviewed indicates some evidence of implementation strategies for machine learning tools in hospital settings. 44 …”

A study of the visualization of artificial intelligence applications in chronic kidney disease in the literature over the last 20 years

“…Two research outbreaks have occurred since 2018: on the one hand, computers objectify patient information data, avoiding the subjectivity of the human brain; on the other hand, computers have a more systematic and simpler way of processing a large number of data samples, which makes it easier for doctors to make clinical decisions based on objectified information data. Machine learning algorithms are able to process and analyze large amounts of medical information data and play an important role in disease diagnosis and prediction [13][14][15] , personalized medicine and precision treatment [16] , surgical planning and decision support [17] , and electronic health record (EHR) analysis [18] . In recent years, a variety of machine learning-based prediction models have been proposed for CKD diagnosis and risk prediction.…”