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      Use of machine learning in geriatric clinical care for chronic diseases: a systematic literature review

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          Abstract

          Objectives

          Geriatric clinical care is a multidisciplinary assessment designed to evaluate older patients’ (age 65 years and above) functional ability, physical health, and cognitive well-being. The majority of these patients suffer from multiple chronic conditions and require special attention. Recently, hospitals utilize various artificial intelligence (AI) systems to improve care for elderly patients. The purpose of this systematic literature review is to understand the current use of AI systems, particularly machine learning (ML), in geriatric clinical care for chronic diseases.

          Materials and Methods

          We restricted our search to eight databases, namely PubMed, WorldCat, MEDLINE, ProQuest, ScienceDirect, SpringerLink, Wiley, and ERIC, to analyze research articles published in English between January 2010 and June 2019. We focused on studies that used ML algorithms in the care of geriatrics patients with chronic conditions.

          Results

          We identified 35 eligible studies and classified in three groups: psychological disorder ( n = 22), eye diseases ( n = 6), and others ( n = 7). This review identified the lack of standardized ML evaluation metrics and the need for data governance specific to health care applications.

          Conclusion

          More studies and ML standardization tailored to health care applications are required to confirm whether ML could aid in improving geriatric clinical care.

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          Most cited references153

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          Deep learning.

          Deep learning allows computational models that are composed of multiple processing layers to learn representations of data with multiple levels of abstraction. These methods have dramatically improved the state-of-the-art in speech recognition, visual object recognition, object detection and many other domains such as drug discovery and genomics. Deep learning discovers intricate structure in large data sets by using the backpropagation algorithm to indicate how a machine should change its internal parameters that are used to compute the representation in each layer from the representation in the previous layer. Deep convolutional nets have brought about breakthroughs in processing images, video, speech and audio, whereas recurrent nets have shone light on sequential data such as text and speech.
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            Aging with multimorbidity: a systematic review of the literature.

            A literature search was carried out to summarize the existing scientific evidence concerning occurrence, causes, and consequences of multimorbidity (the coexistence of multiple chronic diseases) in the elderly as well as models and quality of care of persons with multimorbidity. According to pre-established inclusion criteria, and using different search strategies, 41 articles were included (four of these were methodological papers only). Prevalence of multimorbidity in older persons ranges from 55 to 98%. In cross-sectional studies, older age, female gender, and low socioeconomic status are factors associated with multimorbidity, confirmed by longitudinal studies as well. Major consequences of multimorbidity are disability and functional decline, poor quality of life, and high health care costs. Controversial results were found on multimorbidity and mortality risk. Methodological issues in evaluating multimorbidity are discussed as well as future research needs, especially concerning etiological factors, combinations and clustering of chronic diseases, and care models for persons affected by multiple disorders. New insights in this field can lead to the identification of preventive strategies and better treatment of multimorbid patients. Copyright © 2011 Elsevier B.V. All rights reserved.
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              Artificial intelligence in healthcare: past, present and future

              Artificial intelligence (AI) aims to mimic human cognitive functions. It is bringing a paradigm shift to healthcare, powered by increasing availability of healthcare data and rapid progress of analytics techniques. We survey the current status of AI applications in healthcare and discuss its future. AI can be applied to various types of healthcare data (structured and unstructured). Popular AI techniques include machine learning methods for structured data, such as the classical support vector machine and neural network, and the modern deep learning, as well as natural language processing for unstructured data. Major disease areas that use AI tools include cancer, neurology and cardiology. We then review in more details the AI applications in stroke, in the three major areas of early detection and diagnosis, treatment, as well as outcome prediction and prognosis evaluation. We conclude with discussion about pioneer AI systems, such as IBM Watson, and hurdles for real-life deployment of AI.
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                Author and article information

                Journal
                JAMIA Open
                JAMIA Open
                jamiaoa
                JAMIA Open
                Oxford University Press
                2574-2531
                October 2020
                08 October 2020
                08 October 2020
                : 3
                : 3
                : 459-471
                Affiliations
                School of Systems and Enterprises, Stevens Institute of Technology , Hoboken, New Jersey, USA
                Author notes
                Corresponding Author: Onur Asan, PhD, School of Systems and Enterprises, Stevens Institute of Technology, 1 Castle Point Terrace, Hoboken, NJ 07030, USA: oasan@ 123456stevens.edu
                Author information
                http://orcid.org/0000-0002-5342-0709
                http://orcid.org/0000-0002-9239-3723
                Article
                ooaa034
                10.1093/jamiaopen/ooaa034
                7660963
                33215079
                a102bba6-665b-4ef6-8ea3-3ff0bb088f29
                © The Author(s) 2020. Published by Oxford University Press on behalf of the American Medical Informatics Association.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 08 May 2020
                : 26 June 2020
                : 11 July 2020
                Page count
                Pages: 13
                Categories
                Reviews
                AcademicSubjects/SCI01530
                AcademicSubjects/MED00010
                AcademicSubjects/SCI01060

                machine learning,artificial intelligence,geriatric,chronic diseases,comorbidity,multimorbidity,older patients,ai standards,data governance

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