Artificial Intelligence Applications in Health Care Practice: Scoping Review

BackgroundArtificial intelligence (AI) is often heralded as a potential disruptor that will transform the practice of medicine. The amount of data collected and available in health care, coupled with advances in computational power, has contributed to advances in AI and an ex...

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Main Authors: Malvika Sharma, Carl Savage, Monika Nair, Ingrid Larsson, Petra Svedberg, Jens M Nygren
Format: Article
Language:English
Published: JMIR Publications 2022-10-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2022/10/e40238
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author Malvika Sharma
Carl Savage
Monika Nair
Ingrid Larsson
Petra Svedberg
Jens M Nygren
author_facet Malvika Sharma
Carl Savage
Monika Nair
Ingrid Larsson
Petra Svedberg
Jens M Nygren
author_sort Malvika Sharma
collection DOAJ
description BackgroundArtificial intelligence (AI) is often heralded as a potential disruptor that will transform the practice of medicine. The amount of data collected and available in health care, coupled with advances in computational power, has contributed to advances in AI and an exponential growth of publications. However, the development of AI applications does not guarantee their adoption into routine practice. There is a risk that despite the resources invested, benefits for patients, staff, and society will not be realized if AI implementation is not better understood. ObjectiveThe aim of this study was to explore how the implementation of AI in health care practice has been described and researched in the literature by answering 3 questions: What are the characteristics of research on implementation of AI in practice? What types and applications of AI systems are described? What characteristics of the implementation process for AI systems are discernible? MethodsA scoping review was conducted of MEDLINE (PubMed), Scopus, Web of Science, CINAHL, and PsycINFO databases to identify empirical studies of AI implementation in health care since 2011, in addition to snowball sampling of selected reference lists. Using Rayyan software, we screened titles and abstracts and selected full-text articles. Data from the included articles were charted and summarized. ResultsOf the 9218 records retrieved, 45 (0.49%) articles were included. The articles cover diverse clinical settings and disciplines; most (32/45, 71%) were published recently, were from high-income countries (33/45, 73%), and were intended for care providers (25/45, 56%). AI systems are predominantly intended for clinical care, particularly clinical care pertaining to patient-provider encounters. More than half (24/45, 53%) possess no action autonomy but rather support human decision-making. The focus of most research was on establishing the effectiveness of interventions (16/45, 35%) or related to technical and computational aspects of AI systems (11/45, 24%). Focus on the specifics of implementation processes does not yet seem to be a priority in research, and the use of frameworks to guide implementation is rare. ConclusionsOur current empirical knowledge derives from implementations of AI systems with low action autonomy and approaches common to implementations of other types of information systems. To develop a specific and empirically based implementation framework, further research is needed on the more disruptive types of AI systems being implemented in routine care and on aspects unique to AI implementation in health care, such as building trust, addressing transparency issues, developing explainable and interpretable solutions, and addressing ethical concerns around privacy and data protection.
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spelling doaj.art-f3fce1187b6a408fb1d2b6e30d2d87982023-08-28T23:13:40ZengJMIR PublicationsJournal of Medical Internet Research1438-88712022-10-012410e4023810.2196/40238Artificial Intelligence Applications in Health Care Practice: Scoping ReviewMalvika Sharmahttps://orcid.org/0000-0003-4334-9977Carl Savagehttps://orcid.org/0000-0003-2836-903XMonika Nairhttps://orcid.org/0000-0001-7610-0954Ingrid Larssonhttps://orcid.org/0000-0002-4341-660XPetra Svedberghttps://orcid.org/0000-0003-4438-6673Jens M Nygrenhttps://orcid.org/0000-0002-3576-2393 BackgroundArtificial intelligence (AI) is often heralded as a potential disruptor that will transform the practice of medicine. The amount of data collected and available in health care, coupled with advances in computational power, has contributed to advances in AI and an exponential growth of publications. However, the development of AI applications does not guarantee their adoption into routine practice. There is a risk that despite the resources invested, benefits for patients, staff, and society will not be realized if AI implementation is not better understood. ObjectiveThe aim of this study was to explore how the implementation of AI in health care practice has been described and researched in the literature by answering 3 questions: What are the characteristics of research on implementation of AI in practice? What types and applications of AI systems are described? What characteristics of the implementation process for AI systems are discernible? MethodsA scoping review was conducted of MEDLINE (PubMed), Scopus, Web of Science, CINAHL, and PsycINFO databases to identify empirical studies of AI implementation in health care since 2011, in addition to snowball sampling of selected reference lists. Using Rayyan software, we screened titles and abstracts and selected full-text articles. Data from the included articles were charted and summarized. ResultsOf the 9218 records retrieved, 45 (0.49%) articles were included. The articles cover diverse clinical settings and disciplines; most (32/45, 71%) were published recently, were from high-income countries (33/45, 73%), and were intended for care providers (25/45, 56%). AI systems are predominantly intended for clinical care, particularly clinical care pertaining to patient-provider encounters. More than half (24/45, 53%) possess no action autonomy but rather support human decision-making. The focus of most research was on establishing the effectiveness of interventions (16/45, 35%) or related to technical and computational aspects of AI systems (11/45, 24%). Focus on the specifics of implementation processes does not yet seem to be a priority in research, and the use of frameworks to guide implementation is rare. ConclusionsOur current empirical knowledge derives from implementations of AI systems with low action autonomy and approaches common to implementations of other types of information systems. To develop a specific and empirically based implementation framework, further research is needed on the more disruptive types of AI systems being implemented in routine care and on aspects unique to AI implementation in health care, such as building trust, addressing transparency issues, developing explainable and interpretable solutions, and addressing ethical concerns around privacy and data protection.https://www.jmir.org/2022/10/e40238
spellingShingle Malvika Sharma
Carl Savage
Monika Nair
Ingrid Larsson
Petra Svedberg
Jens M Nygren
Artificial Intelligence Applications in Health Care Practice: Scoping Review
Journal of Medical Internet Research
title Artificial Intelligence Applications in Health Care Practice: Scoping Review
title_full Artificial Intelligence Applications in Health Care Practice: Scoping Review
title_fullStr Artificial Intelligence Applications in Health Care Practice: Scoping Review
title_full_unstemmed Artificial Intelligence Applications in Health Care Practice: Scoping Review
title_short Artificial Intelligence Applications in Health Care Practice: Scoping Review
title_sort artificial intelligence applications in health care practice scoping review
url https://www.jmir.org/2022/10/e40238
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