中国人工智能赋能的临床决策支持系统的应用现状

Abstract

Background: AI-enabled Clinical Decision Support Systems (AI + CDSSs) were heralded to contribute greatly to the advancement of health care services. There is an increased availability of monetary funds and technical expertise invested in projects and proposals targeting the building and implementation of such systems. Therefore, understanding the actual system implementation status in clinical practice is imperative.

Objectives: The aim of the study is to understand (1) the current situation of AI + CDSSs clinical implementations in Chinese hospitals and (2) concerns regarding AI + CDSSs current and future implementations.

Methods: We investigated 160 tertiary hospitals from six provinces and province-level cities. Descriptive analysis, two-sided Fisher exact test, and Mann-Whitney U-test were utilized for analysis.

Results: Thirty-eight of the surveyed hospitals (23.75%) had implemented AI + CDSSs. There were statistical differences on grade, scales, and medical volume between the two groups of hospitals (implemented vs. not-implemented AI + CDSSs, p <0.05). On the 5-point Likert scale, 81.58% (31/38) of respondents rated their overall satisfaction with the systems as "just neutral" to "satisfied." The three most common concerns were system functions improvement and integration into the clinical process, data quality and availability, and methodological bias.

Conclusion: While AI + CDSSs were not yet widespread in Chinese clinical settings, professionals recognize the potential benefits and challenges regarding in-hospital AI + CDSSs.

摘要翻译（仅供参考）

背景：人工智能赋能的临床决策支持系统（AI+CDSSs）将会对医疗保健服务的发展作出巨大贡献。越来越多的资助基金和专业技术被投入到旨在建立和实施这类系统的项目和方案中。因此，了解在临床实践中实际的系统应用现状是至关重要的。 

目的：本研究旨在了解

（1）AI+CDSSs在中国医院的临床应用现状；

（2）对AI+CDSSs目前和未来应用的关注。 

方法： 对6个省和省会城市的160家三级医院进行调查。采用描述性分析，双侧Fisher精确检验和Mann-Whitney U 检验进行分析。 

结果：调查医院中有38家（23.75%）应用了AI+CDSSs。两组医院在级别、量表和医疗量上存在统计学差异（已应用AI+CDSSs组对比未应用AI+CDSSs组，P<0.05）。在Likert 5级量表中，81.58%（31/38）的受访者对系统的总体满意度评价为“一般”到“满意”。三个最常见的问题是系统功能的改进和嵌入临床流程，数据质量和可用性，以及方法学偏差。 

结论：虽然AI+CDSSs在中国临床环境中尚未普及，但专家认识到院内AI+CDSSs的潜在益处和挑战。

Full Text