Moving from bytes to bedside: a systematic review on the use of artificial intelligence in the intensive care unit

Davy van de Sande, Michel E. van Genderen*, Joost Huiskens, Diederik Gommers, Jasper van Bommel

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

92 Citations (Scopus)
88 Downloads (Pure)

Abstract

Purpose: Due to the increasing demand for intensive care unit (ICU) treatment, and to improve quality and efficiency of care, there is a need for adequate and efficient clinical decision-making. The advancement of artificial intelligence (AI) technologies has resulted in the development of prediction models, which might aid clinical decision-making. This systematic review seeks to give a contemporary overview of the current maturity of AI in the ICU, the research methods behind these studies, and the risk of bias in these studies.

Methods: A systematic search was conducted in Embase, Medline, Web of Science Core Collection and Cochrane Central Register of Controlled Trials databases to identify eligible studies. Studies using AI to analyze ICU data were considered eligible. Specifically, the study design, study aim, dataset size, level of validation, level of readiness, and the outcomes of clinical trials were extracted. Risk of bias in individual studies was evaluated by the Prediction model Risk Of Bias ASsessment Tool (PROBAST).

Results: Out of 6455 studies identified through literature search, 494 were included. The most common study design was retrospective [476 studies (96.4% of all studies)] followed by prospective observational [8 (1.6%)] and clinical [10 (2%)] trials. 378 (80.9%) retrospective studies were classified as high risk of bias. No studies were identified that reported on the outcome evaluation of an AI model integrated in routine clinical practice.

Conclusion: The vast majority of developed ICU-AI models remain within the testing and prototyping environment; only a handful were actually evaluated in clinical practice. A uniform and structured approach can support the development, safe delivery, and implementation of AI to determine clinical benefit in the ICU.

Original languageEnglish
Pages (from-to)750-760
Number of pages11
JournalIntensive Care Medicine
Volume47
Issue number7
DOIs
Publication statusPublished - 5 Jun 2021

Bibliographical note

Funding Information:
The authors wish to thank Christa Niehot from the Erasmus MC Medical Library for developing and updating the search strategies.

Publisher Copyright:
© 2021, The Author(s).

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