Faculdade de Medicina da Universidade do Porto Introdução à Medicina II "Artificial Intelligence in Medicine: a survey of interests and beliefs of health researchers from four backgrounds" Turma 7 Orientador: Pedro Pereira Rodrigues Abril de 2010

Contents ● Introduction ● Methods ● Internal Validity Results ● Expected Results

Introduction Artificial Intelligence (AI) is, in a modern definition, the study and design of intelligent agents, where an intelligent agent is a system that perceives its environment and takes actions which maximise chances of success [1]. We decided to add this definition in the introduction due to the feedback we obtained from the Internal Validation. [1] Bernstein RB, Curtis WN, Artificial Intelligence: New Research, 2009

Introduction Impacts and applications of AI ● The AIM field has already produced systems/programs/machines that demonstrate that the application of AI techniques to medical decision is a fruitful methodology. [2] ● Integrating AIM modules into the daily-routine software environment of our care providers gives us a great chance for maintaining and improving quality of care. [3] ● ● [2] SHORTLIFFE EH; AI in medicine comes of age: blossoming or languishing?; 2009; ICAART, 5-6 ● [3] ABBOD MF, LINKENS DA, DOUNIAS G, MAHFOUF M; Survey on the use of smart and adaptive engineering systems in medicine; Artif Intell Med; 26, ; 200 2

Research Question Is Artificial Intelligence relevant and valuable for current applications in Medicine? And in the future?

Aim To survey the different interests and beliefs of four different types of health researchers about Artificial Intelligence in Medicine and its current and future applications.

Specific Objectives ● Assess the different opinions across different types of health researchers: researchers of artificial intelligence in medicine, general clinical practitioners, critical care researchers and medical school deans; ● Identify the different applications/areas of impact/medical fields of AI in Medicine; ● Study the importance and the impact of AI in medical progress;

Specific Objectives Verify the contribution of medical researchers in the development of AI in Medicine Infer on the future application of AI in Medicine

Study design Observational and transversal study, using an online survey, answered by: Directors of European Medical Schools AIM researchers Critical Care researchers General Care researchers

Methods 4 populations Directors of European Medical Schools Researchers of Artificial Intelligence Researchers of Critical Care Researchers of General Practice Journals AIM JAMIA SMMR Journals Critical Care Critical Care in Medicine Intensive Care Journals New England Lancet JAMA

Methods Contacts Collection Journals: Search for s of researchers in each area in the site of the journal in articles of the last 3 years Deans: Search for s of directors of european medical schools in each university site Definition of samples Random selection of 100 contacts of each population

Methods

Internal Validation: ● The questionnaires were sent to teachers of the department to analize and give their opinion about them; ● After this, the surveys were reformulated and they will be sent to the target samples.

Methods Send the survey to 100 s of each population If the number of answer is low, new random selection is made in our populations The surveys are sent again

Methods Fluxogram

Methods Schedule

Methods Survey ● Personalized s will be sent to each population. ● Specific information concerning AI in Medicine will be provided to each group.

Methods Survey ● AIM Researchers

Methods Survey Each population has a group of specific questions. AIM Researchers My research receives the necessary financial support. ● I totally disagree ● I disagree ● I do not have a solid opinion ● I agree ● I totally agree

Methods Survey ● Directors of Medical European Schools

Methods Survey Each population has a group of specific questions. ● Directors of Medical European Schools How would you rate the relevance that your educational institution gives to the promotion of AI in Medicine? ● None ● Low ● Moderate ● High ● Very High ● My Educational Institution shoul give more relevance to the promotion of AI in medicine. ● I totally disagree ● I disagree ● I do not have a solid opinion ● I agree ● I totally agree

Methods Survey ● Critical Care Researchers

Methods Survey Each population has a group of specific questions. ● Critical Care Researchers In which situations do you consider the application of AI most useful? ● Decision support ● Data management ● Data monitoring ● Drug administration ● Other

Methods Survey ● General Practice Researchers

Methods Survey Each population has a group of specific questions. General Practice Researchers AI may improve the work of a general practionier. ● I totally disagree ● I disagree ● I do not have a solid opinion ● I agree ● I totally agree

Statistical Analysis Variables

Internal Validation S tatistical Analysis

Age Minutes spent answering the questionnaire

Internal Validation S tatistical Analysis Yes NoNot sure Nº of cases 2 - Have you ever applied AI in your professional life? 6 5 1

● Seven teachers have answered this question and two of them have chosen two options. ● Data management was the most chosen option Internal Validation S tatistical Analysis Areas of AI application Nº of cases

● From 7 answers, 5 pointed the impact of AI in the experience positive. ● The options “negative” and “extremely negative” weren't chosen. Internal Validation S tatistical Analysis

Rate of the relevance give to AI by the educational institution Internal Validation S tatistical Analysis Nº of cases

Internal Validation S tatistical Analysis Contingency Table – Age and contact with AI

Internal Validation S tatistical Analysis AI can enhance medical education

Internal Validation Necessary modifications

8 - What is the future scenario that you predict for the link between AI and Medicine? Do you believe that, nowadays, it is important to apply AI in Medicine? Why? What benefits may, from your point of view, come out of this association? “AI may be complementary to classical decision making, allowing for better use of data available or its collection in support of medical decisions. “ “In the future, and as a technique starts to make it easier to integrate these systems in real-world scenarios of clinical practice, it seems to me that they come to play an increasingly important role in clinical decision support(...).” Internal Validation S tatistical Analysis

Statistical Analysis SPSS Analysis ● For the Lickert scales, the median will be the appropriate statistical measure. ● To the categorical variables comparison, the Chi- square test will be used.

Expected results ● There will certainly be different opinions based on: ● - Academic background; ● - Medical specialization; ● - Place of work.

Expected results Researchers in Artificial Intelligence AIM Researchers will probably be more receptive in answering the questionnaire and also give highly favorable opinions in relation to the use of these systems in the future.

Expected results Directors of European Medical Schools ● Should be receptive to the use of this technology since it is an excellent teaching and training tool for future physicians. ● It will all depend on the schools, countries and resources available.

Expected results Critical Care Specialists ● Might have a good opinion about AI in Medicine as they work in emergency situations where it is important to be fast in knowing when it is more appropriate to continue diagnosis or begin therapy (this data might be easily obtained using AI). ● We hope to get a considerable amount of answers but highly related to researchers own specialization, since nowadays critical care is intimately related to AI.

Expected results General Practice Researchers ● Will probably have a less beneficial view; ● We believe that the availability to answer will depend mostly on the institution where physicians work and if AI resources are already available there.

Expected difficulties ● Language differences may discourage many from answering the survey. ● Difficulties in analysis and interpretation of the answers. ● Difficulties in the selection of variables to consider. ● Difficulties with the contacts obtained, since some of the s may already be inactive.

Expected difficulties ● Some information contained from the Internet might not be correct, at least regarding contacts that were googled. ● Difficulties in creating questions for the survey. ● Delay in obtaining the answers. ● Difficulties with the creation of the database containing the contact details of researchers. ● People do not always show an interest in answering surveys.