JMIR Publications

ABSTRACT

Background:

Global digitalization continues to advance, extending its influence to medicine and international health care systems. In recent years, significant advancements have been made in the research and development of artificial intelligence (AI), raising questions about its potential in medicine. The integration and application of AI in intensive care medicine, particularly in sepsis treatment, presents significant potential for advancing patient-related outcomes and enhancing patient benefits. However, a comprehensive and systematic overview of the full spectrum of patient-related benefits associated with AI-based CDSS remains lacking.

Objective:

This scoping review aims to identify and categorize evidence on patient-related benefits in the context of AI-based Clinical Decision Support Systems (CDSS) in sepsis care.

Methods:

Systematic research was conducted in 4 electronic databases: MEDLINE via PubMed, Embase, the ACM Digital Library, and IEEE Xplore. In addition, a comprehensive search on the websites of relevant international organizations, along with a citation search of the included articles, was conducted. Articles were included if they (1) focused on sepsis and, (2.1) described patient-related benefits, and/or (2.2) addressed problems in the development, implementation, and/or application of AI-based CDSS, and/or (2.3) proposed strategies for success in AI-based CDSS. The present article examines patient-related benefits. Findings on problems and strategies for success will be published separately. Articles published between January 1, 2008, and March 2, 2023, were considered for inclusion. Study selection was performed independently by 2 reviewers. The manuscript was drafted in accordance with the PRISMA-ScR checklist. The analysis of the included articles was conducted using the programme MAXQDA (VERBI Software GmbH), with systemization finalized in a consensus workshop.

Results:

A total of 3368 records were identified across the 4 databases, of which 24 met the inclusion criteria and were included in the scoping review. The additional search on international websites and in reference lists identified 6 more relevant articles, resulting in a total of 30 included studies. Patient benefits were systemized in 6 main categories: (1) Prediction, (2) Earlier Treatment and Prioritization of High-Risk Patients, (3) Individualized Therapy, (4) Improved Patient Outcomes (including Improved SOFA Score, Reduced Length of Stay, and Reduced Mortality), (5) Improved Care (General), and (6) Reduced Readmission Rate.

Conclusions:

This scoping review underscores the potential of AI-based CDSS to positively impact patient benefits, particularly in sepsis care, where they demonstrate considerable promise for improving intensive care. However, the majority of the identified studies rely on retrospective database analyses. Future research should focus on validating these findings through prospective studies.