Artificial intelligence(AI) is on a rise in science. Using
it in medicine and specifically nephrology is sure to come.
According to the dictionary, AI is “the theory and development of computer
systems able to perform tasks that normally require human intelligence, such as
visual perception, speech recognition, decision-making, and translation between
languages.”
Dr Eric Topol has been
a big proponent of this concept in medicine for years and recently has written
a book called “Deep
Medicine “ that details the potential uses of this in medicine.
Basically, AI can help
in three main ways: 1) diagnosis that is often challenging in various challenging
syndromes and even basic common ones. 2) make the physician’s life easier and
decrease paper work and finally leading to the third -the most important 3) spending
more time at the bedside.
AI is done via creating
an artificial
neural network (ANN ) which is simply a collection of artificial neurons
organized in layers. In a recent article in
AJKD, authors discuss the potential use of this concept in Nephrology. They
describe using it for IgA nephropathy(IgAN) as a recognizable cause for AKI. The ability to identify the patients that
will progress to ESRD with IgAN would be useful for prognostic and therapeutic
reasons. Geddes
et al hypothesized that there exists a function that associates
clinical and biological parameters measured at the time of IgAN diagnosis (namely
age, sex, blood pressure, proteinuria, serum creatinine level, and
antihypertensive treatments) to the probability of developing progressive IgAN.
The authors designed and implemented an ANN to approximate this function. The
results showed that their ANN could predict the occurrence of progressive IgAN
more accurately than experienced nephrologists (correct predictions, 87% vs
69.4%; sensitivity, 86.4% vs 72%; and specificity, 87.5% vs 66%). Hmm, now this
might be interesting to help guide a lot of therapies in Nephrology. This might
be very useful in transplantation and prognosticating even need for dialysis
for the elderly CKD patients.
Interestingly, many AI
algorithms have been approved by FDA that are used in clinical practice:- some
examples are of Atrial fibrillation detection, EF ECHO determination, Coronary
calcium scoring, CT brain bleed diagnosis, device for paramedic stroke diagnosis,
breast density via mammography to name a few.
No nephrology related such algorithms are approved to my knowledge.
There is an entire
journal dedicated for this in medicine now
Nephrologists, let’s get started and catch on!
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