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      Can Artificial Intelligence Improve the Management of Pneumonia

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          Abstract

          The use of artificial intelligence (AI) to support clinical medical decisions is a rather promising concept. There are two important factors that have driven these advances: the availability of data from electronic health records (EHR) and progress made in computational performance. These two concepts are interrelated with respect to complex mathematical functions such as machine learning (ML) or neural networks (NN). Indeed, some published articles have already demonstrated the potential of these approaches in medicine. When considering the diagnosis and management of pneumonia, the use of AI and chest X-ray (CXR) images primarily have been indicative of early diagnosis, prompt antimicrobial therapy, and ultimately, better prognosis. Coupled with this is the growing research involving empirical therapy and mortality prediction, too. Maximizing the power of NN, the majority of studies have reported high accuracy rates in their predictions. As AI can handle large amounts of data and execute mathematical functions such as machine learning and neural networks, AI can be revolutionary in supporting the clinical decision-making processes. In this review, we describe and discuss the most relevant studies of AI in pneumonia.

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          Most cited references13

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          Development and Validation of a Deep Learning–Based Automated Detection Algorithm for Major Thoracic Diseases on Chest Radiographs

          Key Points Question Can a deep learning–based algorithm accurately discriminate abnormal chest radiograph results showing major thoracic diseases from normal chest radiograph results? Findings In this diagnostic study of 54 221 chest radiographs with normal findings and 35 613 with abnormal findings, the deep learning–based algorithm for discrimination of chest radiographs with pulmonary malignant neoplasms, active tuberculosis, pneumonia, or pneumothorax demonstrated excellent and consistent performance throughout 5 independent data sets. The algorithm outperformed physicians, including radiologists, and enhanced physician performance when used as a second reader. Meaning A deep learning–based algorithm may help improve diagnostic accuracy in reading chest radiographs and assist in prioritizing chest radiographs, thereby increasing workflow efficacy.
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            Electronic health record adoption in US hospitals: the emergence of a digital “advanced use” divide

            While most hospitals have adopted electronic health records (EHRs), we know little about whether hospitals use EHRs in advanced ways that are critical to improving outcomes, and whether hospitals with fewer resources – small, rural, safety-net – are keeping up. Using 2008–2015 American Hospital Association Information Technology Supplement survey data, we measured “basic” and “comprehensive” EHR adoption among hospitals to provide the latest national numbers. We then used new supplement questions to assess advanced use of EHRs and EHR data for performance measurement and patient engagement functions. To assess a digital “advanced use” divide, we ran logistic regression models to identify hospital characteristics associated with high adoption in each advanced use domain. We found that 80.5% of hospitals adopted at least a basic EHR system, a 5.3 percentage point increase from 2014. Only 37.5% of hospitals adopted at least 8 (of 10) EHR data for performance measurement functions, and 41.7% of hospitals adopted at least 8 (of 10) patient engagement functions. Critical access hospitals were less likely to have adopted at least 8 performance measurement functions (odds ratio [OR] = 0.58; P  < .001) and at least 8 patient engagement functions (OR = 0.68; P  = 0.02). While the Health Information Technology for Economic and Clinical Health Act resulted in widespread hospital EHR adoption, use of advanced EHR functions lags and a digital divide appears to be emerging, with critical-access hospitals in particular lagging behind. This is concerning, because EHR-enabled performance measurement and patient engagement are key contributors to improving hospital performance. Hospital EHR adoption is widespread and many hospitals are using EHRs to support performance measurement and patient engagement. However, this is not happening across all hospitals.
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              Watson: Beyond Jeopardy!

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                Author and article information

                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                17 January 2020
                January 2020
                : 9
                : 1
                : 248
                Affiliations
                [1 ]Infectious Diseases Department, Hospital Clínic of Barcelona, 08036 Barcelona, Spain; marianachumbita0504@ 123456gmail.com (M.C.); pedro.puerta84@ 123456gmail.com (P.P.-A.); emorenog@ 123456clinic.cat (E.M.-G.); gsg7546@ 123456gmail.com (G.S.); nicole.garciapouton@ 123456gmail.com (N.G.-P.); asoriano@ 123456clinic.cat (A.S.)
                [2 ]Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; catiacilloniz@ 123456yahoo.com (C.C.); atorres@ 123456clinic.cat (A.T.)
                [3 ]Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona, SGR 911-Ciber de Enfermedades Respiratorias (Ciberes), 08036 Barcelona, Spain
                [4 ]School of Medicine, University of Barcelona, 08036 Barcelona, Spain
                Author notes
                [* ]Correspondence: cgarciav@ 123456clinic.cat ; Tel.: +34-93-227-5400 (ext. 2887)
                [†]

                Equal contribution.

                Author information
                https://orcid.org/0000-0002-4646-9838
                https://orcid.org/0000-0002-8643-2167
                Article
                jcm-09-00248
                10.3390/jcm9010248
                7019351
                31963480
                d799d514-0af7-473e-b7be-3835da1f73e3
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 04 December 2019
                : 14 January 2020
                Categories
                Review

                artificial intelligence,pneumonia
                artificial intelligence, pneumonia

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