使用观察性重症监护病房数据进行因果推断:对未来实践进行范围审查和建议
J M Smit1,2, J H Krijthe3, W M R Kant4
1Department of Intensive Care, Erasmus University Medical Center, Rotterdam, The Netherlands. j.smit@erasmusmc.nl.
NPJ digital medicine
|November 27, 2023
概括
本次审查强调了人工智能 (AI) 强大的因果推理模型对于临床决策的关键需求. 在重症监护室 (ICU) 进行因果推理研究的报告标准的改进对于开发可靠的人工智能工具至关重要.
科学领域:
- 医疗信息学 医疗信息学
- 人工智能的人工智能
- 因果推理因果推理
背景情况:
- 可操作的人工智能 (AI) 需要可靠的因果推理模型来支持临床决策.
- 重症监护病房 (ICU) 呈现复杂的场景,时间变化的治疗,需要先进的因果推断方法.
研究的目的:
- 在成年ICU中使用因果推断模型进行研究范围审查.
- 评估这些研究关于目标试验组件和因果假设的报告质量.
- 为加强未来的研究实践提供建议.
主要方法:
- 在多个科学数据库 (如Embase,MEDLINE,Web of Science,arXiv) 中进行系统搜索.
- 包括对成年ICU时间变化的治疗因果推断模型的研究.
- 提取关于研究环境,方法 (G方法,强化学习),治疗方案 (静态,动态),目标试验组件和因果假设的数据.
主要成果:
- 在2184个标题中,有79项研究符合纳入标准.
- G方法 (61%) 和强化学习 (39%) 是主要的方法.
- 报告中发现了重大差距:只有38%的人报告了所有目标试验组件,9%的人提到了所有因果假设.
结论:
- 目前ICU研究中因果推理模型的报告标准不足以开发可操作的AI.
- 建议包括明确定义因果关系问题作为目标试验模拟,采用适当的方法,并严格评估因果关系假设.
- 提高报告质量对于在重症监护机构推进人工智能至关重要.
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