Tutorial: Human-Centered AI: Reliable, Safe and Trustworthy

Background The use of artificial intelligence (AI) algorithms for the diagnosis of skin diseases has shown promise in experimental settings but has not yet been tested in real-life conditions. The COVID-19 pandemic led to a worldwide disruption of health systems, increasing the use of telemedicine. There is an opportunity to include AI algorithms in the teledermatology workflow. Objective The aim of this study is to test the performance of and physicians’ preferences regarding an AI algorithm during the evaluation of patients via teledermatology. Methods We performed a prospective study in 340 cases from 281 patients using patient-taken photos during teledermatology encounters. The photos were evaluated by an AI algorithm and the diagnosis was compared with the clinician’s diagnosis. Physicians also reported whether the AI algorithm was useful or not. Results The balanced (in-distribution) top-1 accuracy of the algorithm (47.6%) was comparable to the dermatologists (49.7%) and residents (47.7%) but superior to the general practitioners (39.7%; P=.049). Exposure to the AI algorithm results was considered useful in 11.8% of visits (n=40) and the teledermatologist correctly modified the real-time diagnosis in 0.6% (n=2) of cases. Algorithm performance was associated with patient skin type and image quality. Conclusions AI algorithms appear to be a promising tool in the triage and evaluation of lesions in patient-taken photographs via telemedicine. Conflicts of Interest None declared.

This article is devoted to the creation of a model of observational diagnostics for patients in dentistry using artificial intelligence as an information and measurement system. Artificial intelligence technology and algorithms in the field of clinical and radiographic image analysis in general dentistry and orthopedics have become the most common systems, contributing to accurate and timely diagnosis of a particular patient. Along with clinical practice images, radiographs are key tools for graphic visualization of the patient's dentition. A model of observational diagnostics for patients using artificial intelligence technology as the latest tool in the healthcare industry can become a structured method of information standardization and measurements in general dentistry. The model of observational diagnostics can serve as a fundamental component of functional diagnostics based on artificial intelligence algorithms, since they have a special potential for increasing the reliability and consistency of diagnostic measurements and information used by a dentist during treatment planning and restoration of the dentition. The model of observational diagnostics of dental patients presented by the authors implies a significant step forward in the development of highprecision methods of functional diagnostics, monitoring and analysis of patient condition measurements. The algorithm of the observational diagnostics model was integrated into the program, the operation of which is based on artificial intelligence technology in order to increase the efficiency, consistency, optimality and accuracy of the processes carried out in clinical practice. The purpose of the study is to determine the characteristics of the model of observational diagnostics of dental patients using artificial intelligence as an information and measuring system. Main results of the study: 1) the characteristics of the practical application of artificial intelligence technology for radiographs, clinical images of patients' teeth are provided; 2) the essential aspects of the model of observational diagnostics of dental patients, as well as the features of its practical application for planning dental treatment of patients are highlighted; 3) the results of practical testing of the model of observational diagnostics of dental patients are reflected (using the example of detection and treatment of caries). Research materials: the results of academic studies on the assessment of functional diagnostics of oral cavity and dentition pathologies using artificial intelligence technology; practical testing of the model of observational diagnostics for dental patients (using the example of detection and treatment of caries in a 49yearold woman). Research methods: systematization, comparative analysis, contrastive analysis, generalization, abstractlogical method, induction, deduction, systems approach, data conceptualization, graphical and tabular visualization of data, construction of informationmeasuring systems, artificial intelligence methods, study of clinical images and radiographs of patients' dental arches. The main conclusions of the study: 1) information and measuring instruments, the operation of which is based on artificial intelligence technology, have become the basis for the rapid processing of significant amounts of information, increasing the accuracy and efficiency of clinical decisions in dentistry. These information and measuring systems allow us to determine complex patterns on radiographs and clinical images of dental arches, to increase the degree of accuracy of functional diagnostics, in particular, in the presence of subtle pathologies and disorders; 2) artificial intelligence technology cannot replace a qualified dentist, such information and measuring systems only complement the accumulated human professional experience, allowing us to jointly carry out functional diagnostics of patients with a dental profile; 3) the potential of artificial intelligence technologies to create comprehensive plans and reports for dental treatment and dental restoration forms the basis for the joint activities of the latest tools and a dentist. In the context of the study, it is noted that artificial intelligence algorithms have become a powerful informationmeasuring tool for improving the decisionmaking process in dental practice, since digital technology promptly and quickly provides feedback to the dentist about missed anomalies or suboptimal methods of dental treatment and restorative medicine. Integration of the model of observational diagnostics for dental patients will make it possible to form an algorithm for the operation of artificial intelligence that fully complies with the recommendations for functional diagnostics and dental treatment of patients, developed on the basis of factual information. The use of artificial intelligence algorithms in dental practice will increase the efficiency of the general industry standard for providing dental services to patients.

A Comprehensive Review of AI Algorithms for Performance Prediction, Optimization, and Process Control in Desalination Systems.

Background As per the Global Burden of Disease Study (GBD) 2019, chronic obstructive pulmonary disease (COPD) and asthma had a significant global burden. COPD is the fourth leading cause of death in the world and the second leading cause of death and disability-adjusted life years (DALYs) in India. Pulmonary function tests (PFTs) are commonly used diagnostic tools. They include spirometry, body plethysmography, and diffusion capacity. In regions with limited resources, pulmonologists often only have access to spirometry. Additionally, PFT pattern interpretation is usually unreliable and subjective. Recent rapid advances in artificial intelligence (AI) algorithms can bridge the gaps. Objectives This study aims to compare the accuracy of the predictions made by AI algorithms with pulmonologists using limited clinical data and spirometry. It also examines the consistency and accuracy of pulmonologists' predictions based on the same information. Methodology Different AI algorithms were trained, and their accuracy was evaluated. Spirometry and limited clinical data from 440 patients were interpreted by an AI algorithm and eight senior pulmonologists. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for the different patterns. Results Approximately 60% of the cases involved male patients, and about 70% were between the ages of 21 and 60. The Fleiss's kappa was 0.46. While the accuracy of pulmonologists against the gold standard was 65.82%, the accuracy of the AI was 86.59%. Conclusions PFTs, when interpreted by pulmonologists with limited clinical and spirometry data, have lower accuracy and higher variability. AI algorithms can consistently produce high accuracy. Adopting such technology among clinicians, especially in resource-constrained regions, could be pivotal for offering quality healthcare. In addition, it will also help in getting rid of inter-observer variability.

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and heterogeneous interstitial lung disease with a median survival of 2–5 years. Though the diagnosis has been improved due to newly published guidelines, the recognition of the prognosis of IPF remains a challenge. Recently, several studies attempted to build prognostic models by extracting predictive variates from pulmonary function data, basic information, or chest computed tomography (CT) and CT-derived parameters with clinical characteristics. Artificial intelligence (AI) algorithms, including principal component analysis, support vector machine, random survival forest, and convolutional neural network, could be applied to the procedure of IPF prognostic model, that is, region of interest extraction, image feature selection, clinical feature selection, and model construction. Compared to human visualization, AI algorithms show a higher efficiency in calculating and extracting deep features and a lower inter-observer variation. Thus, this review provides a comprehensive CT evaluation of IPF prognostic models and discusses the role of AI in constructing IPF prognostic models. The potential improvements of AI in CT assessments, including time-series CT analysis, optimization of AI algorithms, utilization of multi-modal data, and discovery of new biomarkers through unsupervised algorithms, could be introduced to make a more accurate and convenient assessment for the prognosis of IPF patients. This review describes the status quo and future direction of AI applications in CT analysis for prognostic models of IPF.Take home messageThe review summarizes the applications of CT and AI algorithms for prognostic models in IPF and procedures of model construction. It reveals the current limitations and prospects of AI-aid models, and helps clinicians to recognize the AI algorithms and apply them to more clinical work.

BackgroundThe purpose of this scoping review was to explore the current applications of objective gait analysis using inertial measurement units, custom algorithms and artificial intelligence algorithms in detecting neurological and musculoskeletal gait altering pathologies from healthy gait patterns.MethodsLiterature searches were conducted of four electronic databases (Medline, PubMed, Embase and Web of Science) to identify studies that assessed the accuracy of these custom gait analysis models with inputs derived from wearable devices. Data was collected according to the preferred reporting items for systematic reviews and meta-analysis statement guidelines.ResultsA total of 23 eligible studies were identified for inclusion in the present review, including 10 custom algorithms articles and 13 artificial intelligence algorithms articles. Nine studies evaluated patients with Parkinson’s disease of varying severity and subtypes. Support vector machine was the commonest adopted artificial intelligence algorithm model, followed by random forest and neural networks. Overall classification accuracy was promising for articles that use artificial intelligence algorithms, with nine articles achieving more than 90% accuracy.ConclusionsCurrent applications of artificial intelligence algorithms are reasonably effective discrimination between pathological and non-pathological gait. Of these, machine learning algorithms demonstrate the additional capacity to handle complicated data input, when compared to other custom algorithms. Notably, there has been increasing application of machine learning algorithms for conducting gait analysis. More studies are needed with unsupervised methods and in non-clinical settings to better reflect the community and home-based usage.

Trusted evidence. Informed decisions. Better health.

Rationale and Objectives: Accurate diagnosis and staging of cervical precancers is essential for practical medicine in determining the extent of the lesion extension and determines the most correct and effective therapeutic approach. For accurate diagnosis and staging of cervical precancers, we aim to create a diagnostic method optimized by artificial intelligence (AI) algorithms and validated by achieving accurate and favorable results by conducting a clinical trial, during which we will use the diagnostic method optimized by artificial intelligence (AI) algorithms, to avoid errors, to increase the understanding on interpretation of colposcopy images and improve therapeutic planning. Materials and Methods: The optimization of the method will consist in the development and formation of artificial intelligence models, using complicated convolutional neural networks (CNN) to identify precancers and cancers on colposcopic images. We will use topologies that have performed well in similar image recognition projects, such as Visual Geometry Group Network (VGG16), Inception deep neural network with an architectural design that consists of repeating components referred to as Inception modules (Inception), deeply separable convolutions that significantly reduce the number of parameters (MobileNet) that is a class of Convolutional Neural Network (CNN), Return of investment for machine Learning (ROI), Fully Convolutional Network (U-Net) and Overcomplete Convolutional Network Kite-Net (KiU-Net). Validation of the diagnostic method, optimized by algorithm of artificial intelligence will consist of achieving accurate results on diagnosis and staging of cervical precancers by conducting a randomized, controlled clinical trial, for a period of 17 months. Results: We will validate the computer assisted diagnostic (CAD) method through a clinical study and, secondly, we use various network topologies specified above, which have produced promising results in the tasks of image model recognition and by using this mixture. By using this method in medical practice, we aim to avoid errors, provide precision in diagnosing, staging and establishing the therapeutic plan in cervical precancers using AI. Conclusion: This diagnostic method, optimized by artificial intelligence algorithms and validated by the clinical trial, which we consider “second opinion”, improves the quality standard in diagnosing, staging and establishing therapeutic conduct in cervical precancer.

Evaluation of Atrial Fibrillation Risk and Outcome after Allogeneic Transplantation Using an Artificial Intelligence ECG Algorithm and Echocardiographic Parameters in an MDS Cohort

BackgroundHighly accurate detection of intracranial hemorrhages (ICH) on head computed tomography (HCT) scans can prove challenging at high-volume centers. This study aimed to determine the number of additional ICHs detected by an artificial intelligence (AI) algorithm and to evaluate reasons for erroneous results at a level I trauma center with teleradiology services.MethodsIn a retrospective multi-center cohort study, consecutive emergency non-contrast HCT scans were analyzed by a commercially available ICH detection software (AIDOC, Tel Aviv, Israel). Discrepancies between AI analysis and initial radiology report (RR) were reviewed by a blinded neuroradiologist to determine the number of additional ICHs detected and evaluate reasons leading to errors.Results4946 HCT (05/2020-09/2020) from 18 hospitals were included in the analysis. 205 reports (4.1%) were classified as hemorrhages by both radiology report and AI. Out of a total of 162 (3.3%) discrepant reports, 62 were confirmed as hemorrhages by the reference neuroradiologist. 33 ICHs were identified exclusively via RRs. The AI algorithm detected an additional 29 instances of ICH, missed 12.4% of ICH and overcalled 1.9%; RRs missed 10.9% of ICHs and overcalled 0.2%. Many of the ICHs missed by the AI algorithm were located in the subarachnoid space (42.4%) and under the calvaria (48.5%). 85% of ICHs missed by RRs occurred outside of regular working-hours. Calcifications (39.3%), beam-hardening artifacts (18%), tumors (15.7%), and blood vessels (7.9%) were the most common reasons for AI overcalls. ICH size, image quality, and primary examiner experience were not found to be significantly associated with likelihood of incorrect AI results.ConclusionComplementing human expertise with AI resulted in a 12.2% increase in ICH detection. The AI algorithm overcalled 1.9% HCT.Trial registrationGerman Clinical Trials Register (DRKS-ID: DRKS00023593).

The rapid progress of artificial intelligence (AI) algorithms has opened up new opportunities for optimizing energy consumption and promoting sustainable practices in intelligent energy systems. Artificial intelligence algorithms can analyze energy usage patterns and user behavior patterns, further providing support for load balancing, demand side management, and power grid stability optimization calculations, and ultimately providing recommendations for energy-saving practices. This article explores the application of artificial intelligence algorithms in various stages of energy management and optimization from the above three aspects, discusses the models and implementation steps of mainstream artificial intelligence algorithms in each stage, and provides the challenges of utilizing artificial intelligence algorithms in energy systems in the conclusion.

Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This publication is part of a project that has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 954783. Background Stereotactic arrhythmia radio-ablation (STAR) is a promising strategy for the non-invasive treatment of ventricular arrhythmias (VA). The management of the cardio-respiratory motion of the target and the reduction of the uncertainties related to patients’ positioning are two of the main challenges that STAR has to overcome. A prototype of a system was developed that can automatically acquire and interpret echocardiographic images using an artificial intelligence (AI) algorithm to calculate cardiac displacement in real-time. Purpose To evaluate the feasibility of this automatic acquisition system in patients with a history of VA. Methods We conducted a single center, feasibility study enrolling consecutive patients with a history of VA. Echocardiographic images were automatically acquired from the parasternal and apical views with a dedicated probe. The system was designed to hold the probe fixed to the chest in the supine position during both free-breathing and short expiratory breath-hold sequences, to simulate STAR treatment. The primary endpoint was the percentage of patients reaching a score ≥2 in a multi-parametric assessment evaluating the quality of automatically acquired images in terms of: A - allowing a proper identification of the cardiac cycle phase using the AI algorithm, B - allowing a correct measurement of the heart displacement by the AI algorithm, C - ability to visually distinguish typical cardiac structures, and D - stability of the image throughout the respiration cycle. Moreover, we investigated the potential impact of clinical and demographic characteristics on achieving the primary outcome. Results From May to September 2021, we enrolled 24 patients (63±14 years, 21% females). All of them had a history of VA and 21 (88%) had an ICD. Eight patients (33%) had coronary artery disease, 12 (50%) had non-ischemic cardiomyopathy, and 3 had idiopathic VA. Parasternal as well as apical images were obtained from all patients except from one, in whom parasternal view could not be collected due to the patient’s inability to maintain the supine position. The primary outcome was achieved in 23 patients (96%) for the apical view, in 20 patients (87%) for the parasternal view, and in all patients in at least one of the two views. The images quality was maximal (i.e. score=4) in at least one of the two windows in 19 patients (79%). Atrial fibrillation arrhythmia was the only clinical characteristics associated with a poor score outcome in both imaging windows (apical p=0,022, parasternal p=0,014). Conclusion An automatic ultrasonographic image acquisition system associated with an AI algorithm is feasible for real-time monitoring of cardiac motion in patients with a history of VA. The possibility of real-time, non-invasive monitoring of cardiac position would lead to a significant improvement in the quality and safety of STAR treatment, particularly in case of treatment with heavy particles such as protons and carbon ions.

Background and Aims: Embryologist evaluation of embryos is critical for ensuring successful pregnancy outcomes. Standard, manual evaluation is variable, subjective, and time-consuming. The aim of this study was to evaluate whether an artificial intelligence (AI) algorithm can standardize and improve embryo evaluation during IVF. Method: 20 images of blastocyst-stage embryos on day 5 of in vitro development were selected to represent a range of morphological qualities. All embryos had been transferred and the clinical pregnancy outcome was known for each embryo based on detection of fetal heartbeat at first ultrasound scan (∼7-9 weeks gestation). 50% of embryos in the dataset resulted in pregnancy. 158 embryologists made a total of 236 attempts at providing their evaluation of the morphological quality of the 20 embryo images using the Gardner system. The embryologist-assigned grades were then used to generate their prediction of whether that embryo would lead to pregnancy or not (≥ 3BB indicated a pregnancy prediction, and <3BB indicated a non-pregnancy prediction). The same 20 embryo images were also assessed by a previously developed viability AI algorithm for evaluating the likelihood of clinical pregnancy based on embryo images. An AI score of ≥5.0/10 indicated a pregnancy prediction, and <5.0/10 indicated a non-pregnancy prediction. The AI algorithm provided the same score for each embryo image regardless of how many times the analysis was performed. Results: The AI algorithm correctly predicted pregnancy outcome for 14/20 embryo images (70%). Embryologists also correctly predicted 14/20 images in 14/236 attempts (6%), and in 1 attempt correctly predicted 15/20 images. In the remaining 221 attempts (94%) embryologists correctly predicted between 6-13 images, representing a range of accuracies from 30-75%. Conclusion: This study demonstrates the inherent variability and lack of objectivity associated with an embryologist’s evaluation of embryos. It highlights the benefits of accurate AI algorithms for standardizing embryo assessment

Artificial Intelligence–Aided Diagnosis of Breast Cancer Lymph Node Metastasis on Histologic Slides in a Digital Workflow

Artificial intelligence: A promising frontier in bladder cancer diagnosis and outcome prediction.