Toward Artificial Intelligence in Oncology and Cardiology: A Narrative Review of Systems, Challenges, and...

Background: Artificial intelligence (AI), the overarching field that includes machine learning (ML) and its subfield deep learning (DL), is rapidly transforming clinical research by enabling the analysis of high-dimensional data and automating the output of diagnostic and prognostic tests. As clinical trials become increasingly complex and costly, ML-based approaches (especially DL for image and signal data) offer promising solutions, although they require new approaches in clinical education. Objective: Explore current and emerging AI applications in oncology and cardiology, highlight real-world use cases, and discuss the challenges and future directions for responsible AI adoption. Methods: This narrative review summarizes various aspects of AI technology in clinical research, exploring its promise, use cases, and its limitations. The review was based on a literature search in PubMed covering publications from 2019 to 2025. Search terms included "artificial intelligence", "machine learning", "deep learning", "oncology", "cardiology", "digital twin". and "AI-ECG". Preference was given to studies presenting validated or clinically applicable AI tools, while non-English articles, conference abstracts, and gray literature were excluded. Results: AI demonstrates significant potential in improving diagnostic accuracy, facilitating biomarker discovery, and detecting disease at an early stage. In clinical trials, AI improves patient stratification, site selection, and virtual simulations via digital twins. However, there are still challenges in harmonizing data, validating models, cross-disciplinary training, ensuring fairness, explainability, as well as the robustness of gold standards to which AI models are built. Conclusions: The integration of AI in clinical research can enhance efficiency, reduce costs, and facilitate clinical research as well as lead the way towards personalized medicine. Realizing this potential requires robust validation frameworks, transparent model interpretability, and collaborative efforts among clinicians, data scientists, and regulators. Interoperable data systems and cross-disciplinary education will be critical to enabling the integration of scalable, ethical, and trustworthy AI into healthcare.