Dataset Information

Artificial intelligence for clinical oncology.

ABSTRACT: Clinical oncology is experiencing rapid growth in data that are collected to enhance cancer care. With recent advances in the field of artificial intelligence (AI), there is now a computational basis to integrate and synthesize this growing body of multi-dimensional data, deduce patterns, and predict outcomes to improve shared patient and clinician decision making. While there is high potential, significant challenges remain. In this perspective, we propose a pathway of clinical cancer care touchpoints for narrow-task AI applications and review a selection of applications. We describe the challenges faced in the clinical translation of AI and propose solutions. We also suggest paths forward in weaving AI into individualized patient care, with an emphasis on clinical validity, utility, and usability. By illuminating these issues in the context of current AI applications for clinical oncology, we hope to help advance meaningful investigations that will ultimately translate to real-world clinical use.

SUBMITTER: Kann BH

PROVIDER: S-EPMC8282694 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Artificial intelligence for clinical oncology.

Kann Benjamin H BH Hosny Ahmed A Aerts Hugo J W L HJWL

Cancer cell 20210429 7

Clinical oncology is experiencing rapid growth in data that are collected to enhance cancer care. With recent advances in the field of artificial intelligence (AI), there is now a computational basis to integrate and synthesize this growing body of multi-dimensional data, deduce patterns, and predict outcomes to improve shared patient and clinician decision making. While there is high potential, significant challenges remain. In this perspective, we propose a pathway of clinical cancer care touc ...[more]

PMID: 33930310

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Project description:ImportanceMultimodal artificial intelligence (AI) chatbots can process complex medical image and text-based information that may improve their accuracy as a clinical diagnostic and management tool compared with unimodal, text-only AI chatbots. However, the difference in medical accuracy of multimodal and text-only chatbots in addressing questions about clinical oncology cases remains to be tested.ObjectiveTo evaluate the utility of prompt engineering (zero-shot chain-of-thought) and compare the competency of multimodal and unimodal AI chatbots to generate medically accurate responses to questions about clinical oncology cases.Design, setting, and participantsThis cross-sectional study benchmarked the medical accuracy of multiple-choice and free-text responses generated by AI chatbots in response to 79 questions about clinical oncology cases with images.ExposuresA unique set of 79 clinical oncology cases from JAMA Network Learning accessed on April 2, 2024, was posed to 10 AI chatbots.Main outcomes and measuresThe primary outcome was medical accuracy evaluated by the number of correct responses by each AI chatbot. Multiple-choice responses were marked as correct based on the ground-truth, correct answer. Free-text responses were rated by a team of oncology specialists in duplicate and marked as correct based on consensus or resolved by a review of a third oncology specialist.ResultsThis study evaluated 10 chatbots, including 3 multimodal and 7 unimodal chatbots. On the multiple-choice evaluation, the top-performing chatbot was chatbot 10 (57 of 79 [72.15%]), followed by the multimodal chatbot 2 (56 of 79 [70.89%]) and chatbot 5 (54 of 79 [68.35%]). On the free-text evaluation, the top-performing chatbots were chatbot 5, chatbot 7, and the multimodal chatbot 2 (30 of 79 [37.97%]), followed by chatbot 10 (29 of 79 [36.71%]) and chatbot 8 and the multimodal chatbot 3 (25 of 79 [31.65%]). The accuracy of multimodal chatbots decreased when tested on cases with multiple images compared with questions with single images. Nine out of 10 chatbots, including all 3 multimodal chatbots, demonstrated decreased accuracy of their free-text responses compared with multiple-choice responses to questions about cancer cases.Conclusions and relevanceIn this cross-sectional study of chatbot accuracy tested on clinical oncology cases, multimodal chatbots were not consistently more accurate than unimodal chatbots. These results suggest that further research is required to optimize multimodal chatbots to make more use of information from images to improve oncology-specific medical accuracy and reliability.

Project description:Introduction: Prognostic scores are important tools in oncology to facilitate clinical decision-making based on patient characteristics. To date, classic survival analysis using Cox proportional hazards regression has been employed in the development of these prognostic scores. With the advance of analytical models, this study aimed to determine if more complex machine-learning algorithms could outperform classical survival analysis methods. Methods: In this benchmarking study, two datasets were used to develop and compare different prognostic models for overall survival in pan-cancer populations: a nationwide EHR-derived de-identified database for training and in-sample testing and the OAK (phase III clinical trial) dataset for out-of-sample testing. A real-world database comprised 136K first-line treated cancer patients across multiple cancer types and was split into a 90% training and 10% testing dataset, respectively. The OAK dataset comprised 1,187 patients diagnosed with non-small cell lung cancer. To assess the effect of the covariate number on prognostic performance, we formed three feature sets with 27, 44 and 88 covariates. In terms of methods, we benchmarked ROPRO, a prognostic score based on the Cox model, against eight complex machine-learning models: regularized Cox, Random Survival Forests (RSF), Gradient Boosting (GB), DeepSurv (DS), Autoencoder (AE) and Super Learner (SL). The C-index was used as the performance metric to compare different models. Results: For in-sample testing on the real-world database the resulting C-index [95% CI] values for RSF 0.720 [0.716, 0.725], GB 0.722 [0.718, 0.727], DS 0.721 [0.717, 0.726] and lastly, SL 0.723 [0.718, 0.728] showed significantly better performance as compared to ROPRO 0.701 [0.696, 0.706]. Similar results were derived across all feature sets. However, for the out-of-sample validation on OAK, the stronger performance of the more complex models was not apparent anymore. Consistently, the increase in the number of prognostic covariates did not lead to an increase in model performance. Discussion: The stronger performance of the more complex models did not generalize when applied to an out-of-sample dataset. We hypothesize that future research may benefit by adding multimodal data to exploit advantages of more complex models.

Dataset Information

Artificial intelligence for clinical oncology.

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Artificial intelligence for clinical oncology.

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