Making Use of Artificial Intelligence-Generated Synthetic Tympanic Membrane Images.
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ABSTRACT:
SUBMITTER: Suresh K
PROVIDER: S-EPMC10064279 | biostudies-literature | 2023 Jun
REPOSITORIES: biostudies-literature
Publications
Making Use of Artificial Intelligence-Generated Synthetic Tympanic Membrane Images.
Suresh Krish K Cohen Michael S MS Hartnick Christopher J CJ Bartholomew Ryan A RA Lee Daniel J DJ Crowson Matthew G MG
JAMA otolaryngology-- head & neck surgery 20230601 6
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Project description:ImportanceSurgeons make complex, high-stakes decisions under time constraints and uncertainty, with significant effect on patient outcomes. This review describes the weaknesses of traditional clinical decision-support systems and proposes that artificial intelligence should be used to augment surgical decision-making.ObservationsSurgical decision-making is dominated by hypothetical-deductive reasoning, individual judgment, and heuristics. These factors can lead to bias, error, and preventable harm. Traditional predictive analytics and clinical decision-support systems are intended to augment surgical decision-making, but their clinical utility is compromised by time-consuming manual data management and suboptimal accuracy. These challenges can be overcome by automated artificial intelligence models fed by livestreaming electronic health record data with mobile device outputs. This approach would require data standardization, advances in model interpretability, careful implementation and monitoring, attention to ethical challenges involving algorithm bias and accountability for errors, and preservation of bedside assessment and human intuition in the decision-making process.Conclusions and relevanceIntegration of artificial intelligence with surgical decision-making has the potential to transform care by augmenting the decision to operate, informed consent process, identification and mitigation of modifiable risk factors, decisions regarding postoperative management, and shared decisions regarding resource use.
| S-EPMC7286802 | biostudies-literature
Project description:PurposeDeveloping robust artificial intelligence (AI) models for medical image analysis requires large quantities of diverse, well-chosen data that can prove challenging to collect because of privacy concerns, disease rarity, or diagnostic label quality. Collecting image-based datasets for retinopathy of prematurity (ROP), a potentially blinding disease, suffers from these challenges. Progressively growing generative adversarial networks (PGANs) may help, because they can synthesize highly realistic images that may increase both the size and diversity of medical datasets.DesignDiagnostic validation study of convolutional neural networks (CNNs) for plus disease detection, a component of severe ROP, using synthetic data.ParticipantsFive thousand eight hundred forty-two retinal fundus images (RFIs) collected from 963 preterm infants.MethodsRetinal vessel maps (RVMs) were segmented from RFIs. PGANs were trained to synthesize RVMs with normal, pre-plus, or plus disease vasculature. Convolutional neural networks were trained, using real or synthetic RVMs, to detect plus disease from 2 real RVM test datasets.Main outcome measuresFeatures of real and synthetic RVMs were evaluated using uniform manifold approximation and projection (UMAP). Similarities were evaluated at the dataset and feature level using Fréchet inception distance and Euclidean distance, respectively. CNN performance was assessed via area under the receiver operating characteristic curve (AUC); AUCs were compared via bootstrapping and Delong's test for correlated receiver operating characteristic curves. Confusion matrices were compared using McNemar's chi-square test and Cohen's κ value.ResultsThe CNN trained on synthetic RVMs showed a significantly higher AUC (0.971; P = 0.006 and P = 0.004) and classified plus disease more similarly to a set of 8 international experts (κ = 0.922) than the CNN trained on real RVMs (AUC = 0.934; κ = 0.701). Real and synthetic RVMs overlapped, by plus disease diagnosis, on the UMAP manifold, showing that synthetic images spanned the disease severity spectrum. Fréchet inception distance and Euclidean distances suggested that real and synthetic RVMs were more dissimilar to one another than real RVMs were to one another, further suggesting that synthetic RVMs were distinct from the training data with respect to privacy considerations.ConclusionsSynthetic datasets may be useful for training robust medical AI models. Furthermore, PGANs may be able to synthesize realistic data for use without protected health information concerns.
| S-EPMC9560638 | biostudies-literature
Project description:PurposeTo provide a summary of the research advances on ocular images-based artificial intelligence on systemic diseases.MethodsNarrative literature review.ResultsOcular images-based artificial intelligence has been used in a variety of systemic diseases, including endocrine, cardiovascular, neurological, renal, autoimmune, and hematological diseases, and many others. However, the studies are still at an early stage. The majority of studies have used AI only for diseases diagnosis, and the specific mechanisms linking systemic diseases to ocular images are still unclear. In addition, there are many limitations to the research, such as the number of images, the interpretability of artificial intelligence, rare diseases, and ethical and legal issues.ConclusionWhile ocular images-based artificial intelligence is widely used, the relationship between the eye and the whole body should be more clearly elucidated.
| S-EPMC10197476 | biostudies-literature
Project description: Not available
| S-EPMC6710912 | biostudies-literature
Project description:ImportanceThe emergence and promise of generative artificial intelligence (AI) represent a turning point for health care. Rigorous evaluation of generative AI deployment in clinical practice is needed to inform strategic decision-making.ObjectiveTo evaluate the implementation of a large language model used to draft responses to patient messages in the electronic inbox.Design, setting, and participantsA 5-week, prospective, single-group quality improvement study was conducted from July 10 through August 13, 2023, at a single academic medical center (Stanford Health Care). All attending physicians, advanced practice practitioners, clinic nurses, and clinical pharmacists from the Divisions of Primary Care and Gastroenterology and Hepatology were enrolled in the pilot.InterventionDraft replies to patient portal messages generated by a Health Insurance Portability and Accountability Act-compliant electronic health record-integrated large language model.Main outcomes and measuresThe primary outcome was AI-generated draft reply utilization as a percentage of total patient message replies. Secondary outcomes included changes in time measures and clinician experience as assessed by survey.ResultsA total of 197 clinicians were enrolled in the pilot; 35 clinicians who were prepilot beta users, out of office, or not tied to a specific ambulatory clinic were excluded, leaving 162 clinicians included in the analysis. The survey analysis cohort consisted of 73 participants (45.1%) who completed both the presurvey and postsurvey. In gastroenterology and hepatology, there were 58 physicians and APPs and 10 nurses. In primary care, there were 83 physicians and APPs, 4 nurses, and 8 clinical pharmacists. The mean AI-generated draft response utilization rate across clinicians was 20%. There was no change in reply action time, write time, or read time between the prepilot and pilot periods. There were statistically significant reductions in the 4-item physician task load score derivative (mean [SD], 61.31 [17.23] presurvey vs 47.26 [17.11] postsurvey; paired difference, -13.87; 95% CI, -17.38 to -9.50; P < .001) and work exhaustion scores (mean [SD], 1.95 [0.79] presurvey vs 1.62 [0.68] postsurvey; paired difference, -0.33; 95% CI, -0.50 to -0.17; P < .001).Conclusions and relevanceIn this quality improvement study of an early implementation of generative AI, there was notable adoption, usability, and improvement in assessments of burden and burnout. There was no improvement in time. Further code-to-bedside testing is needed to guide future development and organizational strategy.
| S-EPMC10955355 | biostudies-literature
Project description:ImportanceThe transformative potential of artificial intelligence (AI), particularly via large language models, is increasingly being manifested in healthcare. Dietary interventions are foundational to weight management efforts, but whether AI techniques are presently capable of generating clinically applicable diet plans has not been evaluated.ObjectiveOur study sought to evaluate the potential of personalized AI-generated weight-loss diet plans for clinical applications by employing a survey-based assessment conducted by experts in the fields of obesity medicine and clinical nutrition.Design setting and participantsWe utilized ChatGPT (4.0) to create weight-loss diet plans and selected two control diet plans from tertiary medical centers for comparison. Dietitians, physicians, and nurse practitioners specializing in obesity medicine or nutrition were invited to provide feedback on the AI-generated plans. Each plan was assessed blindly based on its effectiveness, balanced-ness, comprehensiveness, flexibility, and applicability. Personalized plans for hypothetical patients with specific health conditions were also evaluated.Main outcomes and measuresThe primary outcomes measured included the indistinguishability of the AI diet plan from human-created plans, and the potential of personalized AI-generated diet plans for real-world clinical applications.ResultsOf 95 participants, 67 completed the survey and were included in the final analysis. No significant differences were found among the three weight-loss diet plans in any evaluation category. Among the 14 experts who believed that they could identify the AI plan, only five did so correctly. In an evaluation involving 57 experts, the AI-generated personalized weight-loss diet plan was assessed, with scores above neutral for all evaluation variables. Several limitations, of the AI-generated plans were highlighted, including conflicting dietary considerations, lack of affordability, and insufficient specificity in recommendations, such as exact portion sizes. These limitations suggest that refining inputs could enhance the quality and applicability of AI-generated diet plans.ConclusionDespite certain limitations, our study highlights the potential of AI-generated diet plans for clinical applications. AI-generated dietary plans were frequently indistinguishable from diet plans widely used at major tertiary medical centers. Although further refinement and prospective studies are needed, these findings illustrate the potential of AI in advancing personalized weight-centric care.
| S-EPMC10991711 | biostudies-literature
Project description:ObjectiveTo develop an artificial intelligence (AI)-based algorithm which can automatically detect food items from images acquired by an egocentric wearable camera for dietary assessment.DesignTo study human diet and lifestyle, large sets of egocentric images were acquired using a wearable device, called eButton, from free-living individuals. Three thousand nine hundred images containing real-world activities, which formed eButton data set 1, were manually selected from thirty subjects. eButton data set 2 contained 29 515 images acquired from a research participant in a week-long unrestricted recording. They included both food- and non-food-related real-life activities, such as dining at both home and restaurants, cooking, shopping, gardening, housekeeping chores, taking classes, gym exercise, etc. All images in these data sets were classified as food/non-food images based on their tags generated by a convolutional neural network.ResultsA cross data-set test was conducted on eButton data set 1. The overall accuracy of food detection was 91·5 and 86·4 %, respectively, when one-half of data set 1 was used for training and the other half for testing. For eButton data set 2, 74·0 % sensitivity and 87·0 % specificity were obtained if both 'food' and 'drink' were considered as food images. Alternatively, if only 'food' items were considered, the sensitivity and specificity reached 85·0 and 85·8 %, respectively.ConclusionsThe AI technology can automatically detect foods from low-quality, wearable camera-acquired real-world egocentric images with reasonable accuracy, reducing both the burden of data processing and privacy concerns.
| S-EPMC8114337 | biostudies-literature
Project description:Artificial intelligence (AI) based on convolutional neural networks (CNNs) has a great potential to enhance medical workflow and improve health care quality. Of particular interest is practical implementation of such AI-based software as a cloud-based tool aimed for telemedicine, the practice of providing medical care from a distance using electronic interfaces. Methods: In this study, we used a dataset of labeled 35,900 optical coherence tomography (OCT) images obtained from age-related macular degeneration (AMD) patients and used them to train three types of CNNs to perform AMD diagnosis. Results: Here, we present an AI- and cloud-based telemedicine interaction tool for diagnosis and proposed treatment of AMD. Through deep learning process based on the analysis of preprocessed optical coherence tomography (OCT) imaging data, our AI-based system achieved the same image discrimination rate as that of retinal specialists in our hospital. The AI platform's detection accuracy was generally higher than 90% and was significantly superior (p < 0.001) to that of medical students (69.4% and 68.9%) and equal (p = 0.99) to that of retinal specialists (92.73% and 91.90%). Furthermore, it provided appropriate treatment recommendations comparable to those of retinal specialists. Conclusions: We therefore developed a website for realistic cloud computing based on this AI platform, available at https://www.ym.edu.tw/~AI-OCT/. Patients can upload their OCT images to the website to verify whether they have AMD and require treatment. Using an AI-based cloud service represents a real solution for medical imaging diagnostics and telemedicine.
| S-EPMC6332801 | biostudies-literature
Project description:BackgroundOtitis media (OM) is the infection and inflammation of the mucous membrane covering the Eustachian with the airy cavities of the middle ear and temporal bone. OM is also one of the most common ailments. In clinical practice, the diagnosis of OM is carried out by visual inspection of otoscope images. This vulnerable process is subjective and error-prone.MethodsIn this study, a novel computer-aided decision support model based on the convolutional neural network (CNN) has been developed. To improve the generalized ability of the proposed model, a combination of the channel and spatial model (CBAM), residual blocks, and hypercolumn technique is embedded into the proposed model. All experiments were performed on an open-access tympanic membrane dataset that consists of 956 otoscopes images collected into five classes.ResultsThe proposed model yielded satisfactory classification achievement. The model ensured an overall accuracy of 98.26%, sensitivity of 97.68%, and specificity of 99.30%. The proposed model produced rather superior results compared to the pre-trained CNNs such as AlexNet, VGG-Nets, GoogLeNet, and ResNets. Consequently, this study points out that the CNN model equipped with the advanced image processing techniques is useful for OM diagnosis. The proposed model may help to field specialists in achieving objective and repeatable results, decreasing misdiagnosis rate, and supporting the decision-making processes.
| S-EPMC7959604 | biostudies-literature
Project description:Recent studies show the potential of artificial intelligence (AI) as a screening tool to detect COVID-19 pneumonia based on chest x-ray (CXR) images. However, issues on the datasets and study designs from medical and technical perspectives, as well as questions on the vulnerability and robustness of AI algorithms have emerged. In this study, we address these issues with a more realistic development of AI-driven COVID-19 pneumonia detection models by generating our own data through a retrospective clinical study to augment the dataset aggregated from external sources. We optimized five deep learning architectures, implemented development strategies by manipulating data distribution to quantitatively compare study designs, and introduced several detection scenarios to evaluate the robustness and diagnostic performance of the models. At the current level of data availability, the performance of the detection model depends on the hyperparameter tuning and has less dependency on the quantity of data. InceptionV3 attained the highest performance in distinguishing pneumonia from normal CXR in two-class detection scenario with sensitivity (Sn), specificity (Sp), and positive predictive value (PPV) of 96%. The models attained higher general performance of 91-96% Sn, 94-98% Sp, and 90-96% PPV in three-class compared to four-class detection scenario. InceptionV3 has the highest general performance with accuracy, F1-score, and g-mean of 96% in the three-class detection scenario. For COVID-19 pneumonia detection, InceptionV3 attained the highest performance with 86% Sn, 99% Sp, and 91% PPV with an AUC of 0.99 in distinguishing pneumonia from normal CXR. Its capability of differentiating COVID-19 pneumonia from normal and non-COVID-19 pneumonia attained 0.98 AUC and a micro-average of 0.99 for other classes.
| S-EPMC8516252 | biostudies-literature