JMIR Publications

ABSTRACT

Background:

Artificial intelligence (AI) applications are growing at an unprecedented pace in health care, ranging from disease diagnosis, triage or screening, risk analysis, surgical operations, and so forth. Despite a great deal of research in the development and validation of healthcare AI, only a few applications have been actually implemented at the frontlines of clinical practice.

Objective:

The objective of this study is to systematically review AI applications that have been implemented in real-life clinical practice.

Methods:

We conducted a literature search in PubMed, Embase, Cochrane Central, and CINAHL to identify relevant articles published between January 2010 and May 2020. We also hand-searched premier computer science journals and conferences as well as registered clinical trials. Studies were included if they reported AI applications that had been implemented in real-world clinical settings.

Results:

We identified 51 relevant studies that reported the implementation and evaluation of AI applications in clinical practice, of which 13 adopted a randomized controlled trial design and 8 adopted an experiment design. The AI applications targeted various clinical tasks such as screening or triage (N=16), disease diagnosis (N=16), risk analysis (N=14), and treatment (N=7). The most commonly addressed diseases and conditions were sepsis (N=6), breast cancer (N=5), diabetic retinopathy (N=4), and polyp and adenoma (N=4). Regarding the evaluation outcomes, we found that 26 studies examined the performance of AI applications in clinical settings, 33 studies examined the effect of AI applications on clinician outcomes, 14 studies examined the effect on patient outcomes, and 1 study examined the economic impacts associated with AI implementation.

Conclusions:

This review indicated that research on clinical implementation of AI applications is still at an early stage despite their great potential. More research needs to assess the benefits and challenges associated with clinical AI applications using a more rigorous methodology. Clinical Trial: Not applicable.