Abstract

In recent years, machine learning (ML) has been promisingly applied in many fields of clinical medicine, both for diagnosis and prognosis prediction. Aims of this narrative review were to summarize the basic concepts of ML applied to clinical medicine and explore its main applications in the emergency department (ED) setting, with a particular focus on syncope management. Through an extensive literature search in PubMed and Embase, we found increasing evidence suggesting that the use of ML algorithms can improve ED triage, diagnosis, and risk stratification of many diseases. However, the lacks of external validation and reliable diagnostic standards currently limit their implementation in clinical practice. Syncope represents a challenging problem for the emergency physician both because its diagnosis is not supported by specific tests and the available prognostic tools proved to be inefficient. ML algorithms have the potential to overcome these limitations and, in the future, they could support the clinician in managing syncope patients more efficiently. However, at present only few studies have addressed this issue, albeit with encouraging results.

Highlights

  • Artificial intelligence (AI) is a broad concept describing computer systems that can perform tasks considered to require ‘human intelligence’

  • We summarize the basic concepts of Machine learning (ML) applied to clinical medicine (Section 2) and explore its main applications in the emergency department (ED) setting (Section 3), with a particular focus on syncope management (Section 4)

  • For each topic, which we addressed in the corresponding subsection, we summarized the results of the studies we considered most significant, highlighting their main remarks and limitations

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Summary

Introduction

Artificial intelligence (AI) is a broad concept describing computer systems that can perform tasks considered to require ‘human intelligence’. ML has been adopted for solving complex problems in most sciences It has been promisingly applied in many fields of clinical medicine, such as radiology [3,4], dermatology [5], ophthalmology [6], and oncology [7,8]. In this narrative review, we summarize the basic concepts of ML applied to clinical medicine (Section 2) and explore its main applications in the emergency department (ED) setting (Section 3), with a particular focus on syncope management (Section 4). In the conclusions (Section 5) we reported the most relevant take home messages from the present review and possible future research directions

What the Clinician Needs to Know about Machine Learning
How Machine Learning Might Help the Emergency Physician
TTriage and Outcomes Prediction
Disease Detection and Prediction
Medical Image Analysis
How Machine Learning Might Help the Physician in ED Syncope Management
Syncope Risk Stratification and ED Disposition
Syncope Detection and Prediction
Findings
Life Parameters and ECG Monitoring
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