Prospective evaluation of artificial intelligence (AI) applications for use in cancer pathways following diagnosis: a systematic review

The role of artificial intelligence (AI) in cancer care has evolved in the face of ageing population, workforce shortages and technological advancement. Despite recent uptake in AI research and adoption, the extent to which it improves quality, efficiency and equity of care beyond cancer diagnostics...

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Main Authors: Ajay Aggarwal, Richard Sullivan, Andrew Hope, Peng Yun Ng, Sheba Macheka
Format: Article
Language:English
Published: BMJ Publishing Group 2024-07-01
Series:BMJ Oncology
Online Access:https://bmjoncology.bmj.com/content/3/1/e000255.full
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author Ajay Aggarwal
Richard Sullivan
Andrew Hope
Peng Yun Ng
Sheba Macheka
author_facet Ajay Aggarwal
Richard Sullivan
Andrew Hope
Peng Yun Ng
Sheba Macheka
author_sort Ajay Aggarwal
collection DOAJ
description The role of artificial intelligence (AI) in cancer care has evolved in the face of ageing population, workforce shortages and technological advancement. Despite recent uptake in AI research and adoption, the extent to which it improves quality, efficiency and equity of care beyond cancer diagnostics is uncertain to date. Henceforth, the objective of our systematic review is to assess the clinical readiness and deployability of AI through evaluation of prospective studies of AI in cancer care following diagnosis.We undertook a systematic review to determine the types of AI involved and their respective outcomes. A PubMed and Web of Science search between 1 January 2013 and 1 May 2023 identified 15 articles detailing prospective evaluation of AI in postdiagnostic cancer pathway. We appraised all studies using Risk of Bias Assessment of Randomised Controlled Trials and Risk of Bias In Non-randomised Studies-of Interventions quality assessment tools, as well as implementational analysis concerning time, cost and resource, to ascertain the quality of clinical evidence and real-world feasibility of AI.The results revealed that the majority of AI oncological research remained experimental without prospective clinical validation or deployment. Most studies failed to establish clinical validity and to translate measured AI efficacy into beneficial clinical outcomes. AI research are limited by lack of research standardisation and health system interoperability. Furthermore, implementational analysis and equity considerations of AI were largely missing.To overcome the triad of low-level clinical evidence, efficacy-outcome gap and incompatible research ecosystem for AI, future work should focus on multicollaborative AI implementation research designed and conducted in accordance with up-to-date research standards and local health systems.
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spelling doaj-art-02c323d1e59a4f3ea2ddbbc56a92ca432025-01-30T09:05:10ZengBMJ Publishing GroupBMJ Oncology2752-79482024-07-013110.1136/bmjonc-2023-000255Prospective evaluation of artificial intelligence (AI) applications for use in cancer pathways following diagnosis: a systematic reviewAjay Aggarwal0Richard Sullivan1Andrew Hope2Peng Yun Ng3Sheba Macheka4Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UKInstitute of Cancer Policy & Centre for Conflict & Health Research, King`s College London, London, UK1 Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UKInstitute of Cancer Policy, King`s College London Faculty of Life Sciences & Medicine, London, UKInstitute of Cancer Policy, King`s College London Faculty of Life Sciences & Medicine, London, UKThe role of artificial intelligence (AI) in cancer care has evolved in the face of ageing population, workforce shortages and technological advancement. Despite recent uptake in AI research and adoption, the extent to which it improves quality, efficiency and equity of care beyond cancer diagnostics is uncertain to date. Henceforth, the objective of our systematic review is to assess the clinical readiness and deployability of AI through evaluation of prospective studies of AI in cancer care following diagnosis.We undertook a systematic review to determine the types of AI involved and their respective outcomes. A PubMed and Web of Science search between 1 January 2013 and 1 May 2023 identified 15 articles detailing prospective evaluation of AI in postdiagnostic cancer pathway. We appraised all studies using Risk of Bias Assessment of Randomised Controlled Trials and Risk of Bias In Non-randomised Studies-of Interventions quality assessment tools, as well as implementational analysis concerning time, cost and resource, to ascertain the quality of clinical evidence and real-world feasibility of AI.The results revealed that the majority of AI oncological research remained experimental without prospective clinical validation or deployment. Most studies failed to establish clinical validity and to translate measured AI efficacy into beneficial clinical outcomes. AI research are limited by lack of research standardisation and health system interoperability. Furthermore, implementational analysis and equity considerations of AI were largely missing.To overcome the triad of low-level clinical evidence, efficacy-outcome gap and incompatible research ecosystem for AI, future work should focus on multicollaborative AI implementation research designed and conducted in accordance with up-to-date research standards and local health systems.https://bmjoncology.bmj.com/content/3/1/e000255.full
spellingShingle Ajay Aggarwal
Richard Sullivan
Andrew Hope
Peng Yun Ng
Sheba Macheka
Prospective evaluation of artificial intelligence (AI) applications for use in cancer pathways following diagnosis: a systematic review
BMJ Oncology
title Prospective evaluation of artificial intelligence (AI) applications for use in cancer pathways following diagnosis: a systematic review
title_full Prospective evaluation of artificial intelligence (AI) applications for use in cancer pathways following diagnosis: a systematic review
title_fullStr Prospective evaluation of artificial intelligence (AI) applications for use in cancer pathways following diagnosis: a systematic review
title_full_unstemmed Prospective evaluation of artificial intelligence (AI) applications for use in cancer pathways following diagnosis: a systematic review
title_short Prospective evaluation of artificial intelligence (AI) applications for use in cancer pathways following diagnosis: a systematic review
title_sort prospective evaluation of artificial intelligence ai applications for use in cancer pathways following diagnosis a systematic review
url https://bmjoncology.bmj.com/content/3/1/e000255.full
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