AIと電子医療記録に基づく初等医療の診断予測モデル:体系的なレビュー
Liesbeth Hunik1, Asma Chaabouni1, Twan van Laarhoven2
1Department of Primary and Community Care, Research Institute for Medical Innovation, Radboudumc, Geert Grooteplein Zuid 21, Nijmegen, 6525 GA, The Netherlands, 31 243618181.
JMIR medical informatics
|August 22, 2025
まとめ
電子医療記録を使用する人工知能モデルは,初等医療診断に有望ですが,さらなる開発が必要です. 現在のAIモデルはバイアスのリスクが高く 臨床使用にはまだ準備ができていません
科学分野:
- 医療情報工学
- 医療における人工知能
- 主要な医療研究
背景:
- 人工知能 (AI) は,電子医療記録 (EHR) のデータを活用することで,プライマリケア (PC) の診断の正確性を向上させる可能性を秘めています.
- AIの潜在能力にもかかわらず,PC EHRデータを用いたAIベースの診断予測モデルの体系的な評価は欠けている.
- 既存の研究は,EHRデータに基づいた様々な予測モデルを探索しているが,包括的なレビューが必要である.
研究 の 目的:
- PC EHRデータを用いて開発されたAIベースの診断予測モデルを体系的に評価する.
- これらのAIモデルの内容,バイアスのリスク,適用性を評価する.
- これらのツールの現在の研究と臨床準備におけるギャップを特定する.
主な方法:
- PRISMAのガイドラインに沿った体系的なレビューが行われました.
- 主要なデータベース (MEDLINE,Embase,Web of Science,Cochrane) で検索を行った.
- PC EHRデータを用いたAI診断予測モデルを開発または検証する研究が含まれ,バイアスのリスクと適用性はPROBASTを使用して評価されました.
主要な成果:
- 10,657件の記録から 15件の論文が選択され,そのほとんどは1つの慢性疾患に焦点を当てていました.
- PC環境で外部で検証されたモデルは2つしかなく,開発されたモデルは13件であった.
- 60% の研究ではバイアスの高いリスクが認められ,報告の欠陥により 67% の研究では適用可能性が不明でした.
結論:
- PCにおけるAIベースの診断予測モデルのほとんどは,単一の慢性疾患に焦点を当てており,プライマリーケアにおける強力な外部検証が欠けている.
- 重要な方法論的限界とバイアスの高いリスクが特定され,臨床実施を阻害しました.
- 現在のAI診断予測モデルは,初等医療における日常的な使用のために十分に開発または検証されていません.
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