When performance is not enough-A multidisciplinary view on clinical decision support.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2023
Historique:
received: 16 09 2022
accepted: 20 02 2023
medline: 26 4 2023
pubmed: 24 4 2023
entrez: 24 04 2023
Statut: epublish

Résumé

Scientific publications about the application of machine learning models in healthcare often focus on improving performance metrics. However, beyond often short-lived improvements, many additional aspects need to be taken into consideration to make sustainable progress. What does it take to implement a clinical decision support system, what makes it usable for the domain experts, and what brings it eventually into practical usage? So far, there has been little research to answer these questions. This work presents a multidisciplinary view of machine learning in medical decision support systems and covers information technology, medical, as well as ethical aspects. The target audience is computer scientists, who plan to do research in a clinical context. The paper starts from a relatively straightforward risk prediction system in the subspecialty nephrology that was evaluated on historic patient data both intrinsically and based on a reader study with medical doctors. Although the results were quite promising, the focus of this article is not on the model itself or potential performance improvements. Instead, we want to let other researchers participate in the lessons we have learned and the insights we have gained when implementing and evaluating our system in a clinical setting within a highly interdisciplinary pilot project in the cooperation of computer scientists, medical doctors, ethicists, and legal experts.

Identifiants

pubmed: 37093808
doi: 10.1371/journal.pone.0282619
pii: PONE-D-22-25782
pmc: PMC10124862
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0282619

Informations de copyright

Copyright: © 2023 Roller et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors declare that there are no competing interests.

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Auteurs

Roland Roller (R)

German Research Center for Artificial Intelligence (DFKI), Berlin, Germany.
Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany.

Aljoscha Burchardt (A)

German Research Center for Artificial Intelligence (DFKI), Berlin, Germany.

David Samhammer (D)

Institute for Systematic Theology II (Ethics), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.

Simon Ronicke (S)

Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany.

Wiebke Duettmann (W)

Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany.
Berlin Institute of Health, Berlin, Germany.

Sven Schmeier (S)

German Research Center for Artificial Intelligence (DFKI), Berlin, Germany.

Sebastian Möller (S)

German Research Center for Artificial Intelligence (DFKI), Berlin, Germany.
Quality and Usability Lab, Technische Universität Berlin, Berlin, Germany.

Peter Dabrock (P)

Institute for Systematic Theology II (Ethics), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.

Klemens Budde (K)

Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany.

Manuel Mayrdorfer (M)

Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany.
Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.

Bilgin Osmanodja (B)

Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany.

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