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Review
. 2020 Jun 5;9(2):13-19.
doi: 10.5492/wjccm.v9.i2.13.

Artificial intelligence and computer simulation models in critical illness

Amos Lal  1 , Yuliya Pinevich  2 , Ognjen Gajic  1 , Vitaly Herasevich  2 , Brian Pickering  2
Affiliations
Review

Artificial intelligence and computer simulation models in critical illness

Amos Lal et al. World J Crit Care Med. .

Abstract

Widespread implementation of electronic health records has led to the increased use of artificial intelligence (AI) and computer modeling in clinical medicine. The early recognition and treatment of critical illness are central to good outcomes but are made difficult by, among other things, the complexity of the environment and the often non-specific nature of the clinical presentation. Increasingly, AI applications are being proposed as decision supports for busy or distracted clinicians, to address this challenge. Data driven "associative" AI models are built from retrospective data registries with missing data and imprecise timing. Associative AI models lack transparency, often ignore causal mechanisms, and, while potentially useful in improved prognostication, have thus far had limited clinical applicability. To be clinically useful, AI tools need to provide bedside clinicians with actionable knowledge. Explicitly addressing causal mechanisms not only increases validity and replicability of the model, but also adds transparency and helps gain trust from the bedside clinicians for real world use of AI models in teaching and patient care.

Keywords: Artificial intelligence; Causation; Critical illness; Digital twin; Predictive enrichment; Simulation models.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Directed acyclic graph of acute brain failure. Orange boxes: Concepts; Orange solid border: Actionable clinical points; Orange interrupted border: Semi-actionable clinical points. GCS: Glasgow coma scale; MAP: Mean arterial pressure; Glu: Serum glucose; Mg: Serum magnesium; Ca: Serum calcium; Meds: Medications; HR: Heart rate; BP: Blood pressure; Focal Def: Focal neurological deficits; ICP: Intracranial pressure; NH3: Ammonia; Na: Serum sodium; Hb: Serum hemoglobin; BUN: Blood urea nitrogen; Osmo: Serum osmolality; TSH: Thyroid stimulating hormone; CO2: Serum carbon dioxide; CPP: Cerebral perfusion pressure; ABI: Acute brain injury; CAM: Confusion assessment method for intensive care unit.
See this image and copyright information in PMC

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