评估人工智能结肠活检查工具所造成的错误的病理和临床影响
Harriet Evans1,2, Naveen Sivakumar3, Shivam Bhanderi4
1University of Warwick, Coventry, UK harriet.evans4@nhs.net.
BMJ open gastroenterology
|January 6, 2025
概括
用于结肠活检诊断的AI工具IGUANA在病例中具有7.9%的错误率,但大多数假负错误不会伤害患者. 临床背景是医疗保健中安全采用人工智能的关键.
科学领域:
- 组织病理学 组织病理学
- 人工智能的人工智能
- 数字病理学数字病理学
背景情况:
- 人工智能 (AI) 对改善医疗保健中的组织学诊断具有重大前景.
- 人工智能工具的采用受到缺乏对其临床背景的理解的阻碍.
- IGUANA是一种AI算法,旨在分类结肠活检并自动报告正常病例.
研究的目的:
- 为了回顾IGUANA AI算法在分类结肠活检时所犯的错误.
- 评估虚假阴性 (FN) 错误的病理和临床影响,优先考虑具有最大危害潜力的错误.
主要方法:
- 来自2080名患者的5054张整片图像 (WSIs) 的病理评估,重点关注FN错误.
- 评估WSI质量,准确诊断错过的实体,以及影响诊断错误的因素.
- 临床评估每个FN错误对患者护理的影响,包括错过的诊断,调查或治疗.
主要成果:
- 在164个案例中,共发生220个FN错误 (4.4%的WSIs,7.9%的案例).
- 错误范围从腺癌到轻度炎症;88.4%的FN错误对患者的护理没有影响.
- 减轻危害的因素包括低风险的息肉或在其他活检中检测出诊断特征;只有一个错误造成了重大伤害.
结论:
- 大多数来自IGUANA AI工具的FN错误不太可能对患者造成伤害.
- 尽管病例级错误率为7.9%,但当考虑临床背景时,人工智能工具可能适合采用.
- 在临床环境中评估AI错误对于在医疗保健环境中安全有效实施至关重要.
相关概念视频
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
48
This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
48
01:10Documentation of Nursing Diagnosis
1.2K
The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
1.2K
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
135
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
135
01:25Endoscopic Procedures II: Colonoscopy
56
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
56
01:25Assessment of the Rectum and Anus
150
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
150