Artificial intelligence in respiratory medicine: From diagnosis to treatment and future directions

Lung diseases-including lung cancer, chronic obstructive pulmonary disease (COPD), asthma, interstitial lung diseases (ILDs), and rare conditions like cystic fibrosis-remain major drivers of global morbidity and mortality. Timely diagnosis and individualized treatment are frequently challenged by heterogeneous clinical phenotypes and the complexity of multimodal data. This review provides a critical synthesis of the transformative role of artificial intelligence (AI) in respiratory care, tracing the paradigm shift from classical machine learning to emerging large language models (LLMs) and multimodal foundation models. We evaluate the performance of AI across the patient care continuum: beginning with radiologist-level nodule detection and automated diagnostics, advancing into AI-powered clinical decision support systems (CDSS) and surgical/radiotherapeutic interventions, and culminating in prognostic modeling and "digital twin" simulations for longitudinal patient management. Furthermore, we explore the translational frontier of precision medicine, examining how AI leverages multi-omics and liquid biopsies to drive novel biomarker discovery and accelerate drug repurposing. Finally, we address persistent sociotechnical barriers-including data sovereignty, legal liability, and the critical need for prospective clinical validation-proposing a translational roadmap for the safe integration of generalist medical AI into clinical workflows.