Artificial Model Research Articles

Computerized diagnostic decision support systems- a comparative performance study of Isabel Pro vs. ChatGPT4.

Validate the diagnostic accuracy of the Artificial Intelligence Large Language Model ChatGPT4 by comparing diagnosis lists produced by ChatGPT4 to Isabel Pro. This study used 201 cases, comparing ChatGPT4 to Isabel Pro. Systems inputs were identical. Mean Reciprocal Rank (MRR) compares the correct diagnosis's rank between systems. Isabel Pro ranks by the frequency with which the symptoms appear in the reference dataset. The mechanism ChatGPT4 uses to rank the diagnoses is unknown. A Wilcoxon Signed Rank Sum test failed to reject the null hypothesis. Both systems produced comprehensive differential diagnosis lists. Isabel Pro's list appears immediately upon submission, while ChatGPT4 takes several minutes. Isabel Pro produced 175 (87.1 %) correct diagnoses and ChatGPT4 165 (82.1 %). The MRR for ChatGPT4 was 0.428 (rank 2.31), and Isabel Pro was 0.389 (rank 2.57), an average rank of three for each. ChatGPT4 outperformed on Recall at Rank 1, 5, and 10, with Isabel Pro outperforming at 20, 30, and 40. The Wilcoxon Signed Rank Sum Test confirmed that the sample size was inadequate to conclude that the systems are equivalent. ChatGPT4 fabricated citations and DOIs, producing 145 correct references (87.9 %) but only 52 correct DOIs (31.5 %). This study validates the promise of Clinical Diagnostic Decision Support Systems, including the Large Language Model form of artificial intelligence (AI). Until the issue of hallucination of references and, perhaps diagnoses, is resolved in favor of absolute accuracy, clinicians will make cautious use of Large Language Model systems in diagnosis, if at all.

Evaluation of Anti‐inflammatory Activity of Garlic Extracts in 3D Bioprinted Skin Equivalents

Ongoing obstacles in preclinical drug testing have raised significant concerns within the pharmaceutical industry. Recently, utilizing the potential of three‐dimensional (3D) bioprinting offers a solution for creating tissue models for screening of the effectiveness and safety of new drugs. In this study, the anti‐inflammatory potential of garlic extracts is assessed, specifically N‐Benzyl‐N‐methyl‐dodecan‐1‐amine (BMDA), using a 3D bioprinted artificial skin model. Comprehensive physicochemical characterization and immunocytochemical analysis demonstrate that the 3D bioprinted skin model exhibits structures and functions resembling human skin. BMDA treatment in a prepared skin model reveals its capacity to mitigate H2O2‐induced oxidative stress and trigger anti‐inflammatory responses. Notably, BMDA reduces the expression of pro‐inflammatory cytokines and chemokines by downregulating NF‐κB and mitogen‐activated protein kinase inflammatory signaling pathways. In summary, our findings highlight the potential of an artificial skin model as a robust platform for the development of new drugs.

Abstract PO4-07-02: Development of an Artificial Intelligence-based breast cancer detection model using Plasma Lipidomic Signature

Abstract Background: Mammography is the current diagnostic standard for breast cancer screening and monitoring. However, accessibility challenges, accuracy issues and patient discomfort all contribute to reduced patient compliance and utilization, resulting in a need for more effective diagnostic tools. An artificial intelligence (AI)-based lipidomic blood test may add significant value to early breast cancer detection rate and improve outcomes for patients. We have previously reported a series of lipidomic studies (n=793) and derived a lipid signature from plasma-enriched extracellular vesicles (EVs) that effectively distinguished people with localized breast cancer from cancer-free controls. Here we report the development of a breast cancer detection AI model from lipidomic data assessed directly using plasma samples. Methods: Lipids in both EVs and plasma collected from fasted breast cancer and control blood samples (n=256) were extracted and analysed by liquid chromatography-high resolution mass spectrometry (LC-HRAM-MS). Over 400 manually curated lipids were quantified. A bootstrapped analysis using Boruta, a robust and statistically rigorous feature selection algorithm based on random forest feature importance, was employed to identify cancer discriminatory lipid signatures in EV and plasma lipidomes consistently selected across 2000 bootstrap samples. The resulting lipid signature was then used to train an ensemble of 18 distinct machine learning models for cancer status prediction using a majority vote to aggregate the individual predictions. Model performance and variability were assessed over 2000 iterations of leave-group-out cross-validation (LGOCV) using an 80/20 train-test split. Average patient-level predictions across LGOCV iterations were recorded for both EV-and plasma-derived models and the two modalities were compared using an exact paired samples test (McNemar’s test). Results: Both the EV- and plasma-derived lipid signatures performed well in distinguishing breast cancer samples from controls. The development of a bioinformatics AI pipeline enabled the creation of a robust ensemble model achieving an F1 score of 0.89 in plasma with LGOCV. The final plasma ensemble predictive performance of 86.1% (±4.5%) in accuracy, 91.4% (±5.4%) in sensitivity, and 78.7% (±8.6%) specificity was achieved, which is comparable to that of EV (accuracy: 86.1±4.4%, sensitivity: 90.4±5.3%, specificity: 80.2±8.7%). Paired samples analysis using McNemar’s test indicated no significant differences between models trained on EV- and plasma-derived lipid signatures in either the sensitivity (p=0.65), specificity (p=0.49), or accuracy (p=0.42). Conclusion: The initial study demonstrated the high performance of a plasma-enriched extracellular vesicle-derived lipid biomarker signature for early breast cancer detection. Direct assessment of the lipidomic signature from plasma showed promise in simplifying the test. Assessing plasma directly offered advantages in terms of scalability, higher throughput, and ease of implementation. Further verification of the lipid signature in an upcoming study involving 500 plasma samples is planned. Ongoing studies will further optimize the plasma lipidomic signature and strengthen our AI pipeline. These findings support the potential clinical application of AI-based lipidomic profiling as a blood-based screening tool for breast cancer detection. Citation Format: Ameline Lim, Cheka Kehelpannala, Fatemeh Vafaee, Forrest Koch, Dana Pascovici, Desmond Li, Kerry Heffernan, Gillian Lamoury, Amani Batarseh, Bruce Mann. Development of an Artificial Intelligence-based breast cancer detection model using Plasma Lipidomic Signature [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-07-02.

Abstract PO2-01-14: Development of Artificial Intelligence-based Machine Learning Models for Predicting Survival In Hormone-Receptor-Positive/HER2-Negative Early Breast Cancer undergoing Neoadjuvant Chemotherapy

Abstract Background. In hormone-receptor positive (HoR)/HER2 negative early breast cancer (BC) multiple efforts have been made to predict disease recurrence and survival. Machine learning techniques have been used but few studies have looked into their applicability in predicting survival on the basis of clinico-pathological characteristics. The aim of this study was to evaluate a random survival forest model to predict the prognosis of this specific BC subtype. Methods. In this multicenter, retrospective study, patients who fulfilled the following inclusion criteria were included: (1) diagnosis of pathologically confirmed HoR-positive/HER2-negative invasive BC; (2) early or locally advanced, stage I-II-III (3) patients receiving neoadjuvant anthracycline and/or taxane-based chemotherapy, concurrently or sequentially; (4) patients undergoing surgery for primary BC. Survival endpoints were disease-free survival (DFS) and overall survival (OS). A random survival forest algorithm was used to develop the predictive model. Ten-fold cross-validation was performed. The C-index and the continuous rank probability score (CRPS) were used to evaluate the discrimination of the predictive model, and a ROC curve was used to evaluate model precision. A cut point analysis based on maximally selected rank statistics was conducted to evaluate the best cut-off in the out-of-bag (OOB) mortality that could maximize DFS and OS prediction. Variable importance was assessed using Breiman-Cutler permutation importance. Results. Overall, 572 patients with HoR-positive/HER2-negative early BC were included. At univariate analysis age, T stage, N stage, grading, ER, PR and Ki67 were found to be significantly associated with DFS and ER, PgR, HER2, pCR ypT and ypN retained statistical significance at multivariate analysis. ER, pCR, pathological T and N stage were found to be significantly associated with OS at univariate and multivariate analysis. The following variables were included in the final model: menopausal status, age, histology, grade, clinical T/N, ER/PgR, Ki67 and HER2, pathological complete response (pCR), ypT and ypN. For DFS, the cross-validated C-index was 0.68 (95% CI 0.63-0.73) and the OOB CRPS was 0.15, with a OOB performance error of 0.31. The AUC calculated at 60 months was 0.91 (95% CI 0.88-0.94). Out-of bag RSF-based risk scores for individual patients were calculated and an optimal cut-off of 22.58 was identified. The HR between high risk and low risk group was 3.08 (95% CI 2.16-4.39, p< 0.001). For OS, the cross-validated C-index was 0.66 (95% CI 0.60-0.71) and the OOB CRPS was 0.17, with a OOB performance error of 0.35. The AUC calculated at 60 months 0.91 (95% CI 0.88-0.95). An optimal cut-off of 21.54 was identified and the HR between low risk and high risk group was 2.50 (95% CI 1.73-3.61, p< 0.001). For DFS, the most important variables were cN (9.00), ypN (7.35), ER (7.21), ypT (5.38), PgR (4.11), pCR (4.01) and age (2.82) while for OS the most important variables were cN (7.88), ER (5.37), PgR (3.61), age (3.37), pCR (2.80), ypT (2.64) and ypN (2.60). Discussion. We analyzed the performance of RSF in the prediction of DFS and OS based on the contribution of clinico-pathological features commonly available at the baseline of the NCT and post-surgery. By selecting patients with HoR-positive HER2-negative disease, we were able to show which clinico-pathological features within a ML model have greater predictive importance. The model could be integrated with image-based tumor and radiology features to improve its predictive accuracy. This retrospective multicenter study suggests that the combination of easily accessible clinico-pathological features within a ML model may reliably predict DFS and OS in the context of HoR-positive/HER2-negative BCs. Citation Format: Luca Mastrantoni, Giovanna Garufi, Noemi Maliziola, Elena Di Monte, Giorgia Arcuri, Valentina Frescura, Angelachiara Rotondi, Giulia Giordano, Luisa Carbognin, Alessandra Fabi, Ida Paris, Gianluca Franceschini, Armando Orlandi, Antonella Palazzo, Giovanni Scambia, Giampaolo Tortora, Emilio Bria. Development of Artificial Intelligence-based Machine Learning Models for Predicting Survival In Hormone-Receptor-Positive/HER2-Negative Early Breast Cancer undergoing Neoadjuvant Chemotherapy [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-01-14.

Comparing discriminating abilities of evaluation metrics in link prediction

Abstract Link prediction aims to predict the potential existence of links between two unconnected nodes within a network based on the known topological characteristics. Evaluation metrics are used to assess the effectiveness of algorithms in link prediction. The discriminating ability of these evaluation metrics is vitally important for accurately evaluating link prediction algorithms. In this study, we propose an artificial network model, based on which one can adjust a single parameter to monotonically and continuously turn the prediction accuracy of the specifically designed link prediction algorithm. Building upon this foundation, we show a framework to depict the effectiveness of evaluating metrics by focusing on their discriminating ability. Specifically, a quantitative comparison in the abilities of correctly discerning varying prediction accuracies was conducted encompassing nine evaluation metrics: Precision, Recall, F1-Measure, Matthews Correlation Coefficient (MCC), Balanced Precision (BP), the Area Under the receiver operating characteristic Curve (AUC), the Area Under the Precision-Recall curve (AUPR), Normalized Discounted Cumulative Gain (NDCG), and the Area Under the magnified ROC (AUC-mROC). The results indicate that the discriminating abilities of the three metrics, AUC, AUPR, and NDCG, are significantly higher than those of other metrics.

Artificial neural network-based positioning error modeling and compensation for low-cost encoders of four-wheeled vehicles

Artificial neural network-based positioning error modeling and compensation for low-cost encoders of four-wheeled vehicles

Online training for hearing implant surgery : Anew approach to otological training.

Education in microsurgery of the ear includes staged training to allow for mastering of the complex microsurgical procedures, particularly in the context of middle ear reconstruction and cochlear implantation. Traditional surgical training includes temporal bone preparations by cadaver dissection and supervised operating room practice. As these on-site trainings are limited, there is aneed to broaden education facilities in an on-line format. Therefore, afirst basic on-line training for otosurgery was developed. The system consists of an artificial temporal bone model together with aset of basic surgical instruments and implant dummies. As an essential part of the training kit, ahigh-resolution camera set is included that allows for connection to avideo streaming platform and enables remote supervision of the trainees' surgical steps by experienced otological surgeons. In addition, apre-learning platform covering temporal bone anatomy and instrumentation and pre-recorded lectures and instructional videos has been developed to allow trainees to review and reinforce their understanding before hands-on practice. Over the three courses held to date, 28participants with varying levels of prior surgical experience took part in this otological surgical training program. The immediate feedback of the participants was evaluated by means of aquestionnaire. On this basis, the high value of the program became apparent and specific areas could by identified where further refinements could lead to an even more robust training experience. The presented program of an otosurgical online training allows for basal education in practical exercises on aremote system. In this way, trainees who have no direct access to on-site instruction facilities in ear surgery now have the chance to start their otosurgical training in an educational setting adapted to modern technologies.

Development and validation of an artificial intelligence-based model for detecting urothelial carcinoma using urine cytology images: a multicentre, diagnostic study with prospective validation

Development and validation of an artificial intelligence-based model for detecting urothelial carcinoma using urine cytology images: a multicentre, diagnostic study with prospective validation

Compound-choking theory and artificial neural networks-based hybrid modeling for supersonic ejectors

As the core component of ejector refrigeration systems, the research of ejector mechanisms has always been a hot topic. Based on the compound-choking theory, this paper studies the relationship between the entrainment ratio and critical back pressure and designs a neural network-based online error compensation mechanism for supersonic ejectors. Firstly, a thermodynamic model of the ejector is developed by combining the ideal gas model, the compound-choking theory, and the constant-pressure mixing theory. Then, the thermodynamic relationship between the entrainment ratio and critical back pressure is derived by introducing the idea of a hypothetical mixing cross section. Compared with the existing results, our method is able to improve critical back pressure prediction accuracy by virtue of the actual entrainment ratio. Therefore, a new adaptive error compensation algorithm is proposed for supersonic ejectors based on neural networks. Thus, the proposed scheme can be regarded as a hybrid modeling method for supersonic ejectors, which combines thermodynamic laws and data-driven artificial intelligence algorithms. Experimental data from ejector refrigeration systems with R141b, R245fa, water vapor and R134a are used in this paper to verify the validity of the model. The simulation results show that our method can effectively predict the critical back pressure, and all the prediction errors are less than 10%.

Machine learning methods for predicting CO2 solubility in hydrocarbons

The application of carbon dioxide (CO2) in enhanced oil recovery (EOR) has increased significantly, in which CO2 solubility in oil is a key parameter in predicting CO2 flooding performance. Hydrocarbons are the major constituents of oil, thus the focus of this work lies in investigating the solubility of CO2 in hydrocarbons. However, current experimental measurements are time-consuming, and equations of state can be computationally complex. To address these challenges, we developed an artificial intelligence-based model to predict the solubility of CO2 in hydrocarbons under varying conditions of temperature, pressure, molecular weight, and density. Using experimental data from previous studies, we trained and predicted the solubility using four machine learning models: support vector regression (SVR), extreme gradient boosting (XGBoost), random forest (RF), and multilayer perceptron (MLP). Among four models, the XGBoost model has the best predictive performance, with an R2 of 0.9838. Additionally, sensitivity analysis and evaluation of the relative impacts of each input parameter indicate that the prediction of CO2 solubility in hydrocarbons is most sensitive to pressure. Furthermore, our trained models were compared with existing models, demonstrating higher accuracy and applicability of our models. The developed machine learning-based models provide a more efficient and accurate approach for predicting CO2 solubility in hydrocarbons, which may contribute to the advancement of CO2-related applications in the petroleum industry.

Artificial intelligence-based prediction models of bio-treated sand strength for sustainable and green infrastructure applications

As a sustainable, environmentally friendly, and green solution, biomineralization/bio-treatment process has recently emerged for enhancing the strength characteristics of loose sands by inducing cementation material commonly referred to as microbially induced calcite/cementation precipitation (MICP). To date, existing research on the unconfined compression strength of MICP-treated sands (UCSmicp) relies heavily on experimental data, with predictions primarily based on linear or curvilinear models that consider calcite (CaCO3) as the main influencing factor. However, there is limited exploration into the application of artificial intelligence (AI) and machine learning (ML) methods for UCSmicp prediction involving multiple influencing factors and their validation on unseen laboratory data. Therefore, this study intends to propose new prediction models of UCSmicp using four advanced ML techniques: Gaussian Process Regression (GPR), Adaptive Neuro Fuzzy Inference System (ANFIS), Artificial Neural Network (ANN), and Gene Expression Programming (GEP). The models incorporate various factors affecting UCSmicp, including sand uniformity coefficient (Cu), initial void ratio (e), mean grain size (D50), optical density at 600 mm wavelength (OD600), urea concentration (U), calcium concentration (Ca), and calcite content (C). Performance evaluation of models involved statistical assessments, error analysis, cross validation on laboratory data, and sensitivity and monotonicity studies. Results indicate that the proposed models exhibit exceptional precision across training, testing, and validation data in predicting UCSmicp, with ANN demonstrating the highest accuracy, followed by GPR, ANFIS, and GEP. Sensitivity analysis identifies CaCO3 as the main influencing factor on UCSmicp, while monotonicity analysis confirms alignment with physical processes. This work advocates for MICP as an eco-friendly solution and highlights the efficacy of advanced ML techniques in fostering sustainable infrastructure.

B-32 | Comparison of Artificial Intelligence Language Models ChatGPT Versus BARD for Recommendations for Cardiovascular Disease Prevention Queries

B-32 | Comparison of Artificial Intelligence Language Models ChatGPT Versus BARD for Recommendations for Cardiovascular Disease Prevention Queries

Determination of hardness and Young's modulus in fcc Cu-Ni-Sn-Al alloys via high-throughput experiments, CALPHAD approach and machine learning

Hardness and Young's modulus are critical indicators in the design of innovative Cu-Ni-Sn-Al alloys with desired elastic and strength properties. In this study, the composition-dependent hardness and Young's modulus in the fcc Cu-Ni-Sn-Al alloys were determined using high-throughput experiments, the CALPHAD (CALculation of PHAse Diagrams) approach, and machine learning (ML) model. By combining the diffusion-couples tool, nanoindentation, and electron probe microanalysis (EPMA) techniques, the 341 sets of composition-related hardness and Young's modulus in the fcc Cu-Ni-Sn-Al system, as well as its sub-binary and sub-ternary systems, were effectively determined. These measured data were subsequently utilized to establish the relationship of Young's modulus and hardness with respect to composition in the fcc Cu-Ni-Sn-Al system through the combined application of CALPHAD and back propagation (BP) artificial neural network machine learning models. A comparison between the two approaches revealed that the ML method achieves higher accuracy in ternary and quaternary alloys compared to the CALPHAD method. The impact of alloying elements on the values of hardness and Young's modulus was analyzed, demonstrating that the Ni content has the largest effect on hardness, while the Young's modulus increases with addition of Ni but decreases with the addition of Al and Sn. Finally, the effects of solute elements on the nanomechanical properties of aged Cu1-x(Ni3Sn)x and Cu-9Ni-6Sn-xAl alloys were examined.

Comprehensive Overview of GAN Technology: Architecture, Training, and Applications

Abstract: Generative Adversarial Networks (GANs) is a groundbreaking artificial intelligence technology that transforms generative modeling through the implementation of a novel adversarial training framework. GANs are made up of two neural networks, the generator and the discriminator, which compete in a minimax game in order to generate counterfeit samples of data and distinguish between real and fake data. This adversarial training method results in the creation of highly proficient generative models capable of producing data that is identical to real-world samples. GANs have been shown to have significant outcomes in a variety of programs, consisting of synthesizing images, style transfer, medical visualization, and natural language processing. However, GANs encounter difficulties with problems like mode collapse and operational irregularities. Presently, research is aimed at tackling these problems and strengthening GAN frameworks and training approaches. GANs’ adaptability and perspective contribute to an intriguing technology for a wide range of sectors and artistic activities, with consequences for artificial intelligence growth and generative modeling breakthroughs. GANs incorporate the potential of competitive training with their capacity to generate extremely realistic data in a variety of domains. We will begin by looking at the fundamental concepts, and underlying principles that reinforce GANs, and their general architecture, investigate their different possible uses, and discuss the obstacles and potential developments in this instantly transforming field.

Management of methane emission in coal mines using artificial neural networks: A systematic review

Underground mines are responsible for a large number of the released methane worldwide. Our study paper can contribute to mitigating methane emissions, hence reducing the concentration about greenhouse emissions within the environment and mitigating the associated hazardous risks. In this study, more than 45 recent journals on Methane emission in Coal Mines were gathered from Web of Science, IEEE Xplore, ScienceDirect, and ResearchGate. A systematic review is accomplished of the past four years of various parts of Methane gas emission such as anthropogenic emission sources, gas emissions detection, prediction of methane using different technology and the Artificial intelligence projection model for methane emission. The outcomes reveal that since the methane emission management has obtained increasing attention over the past four years. This study also shows that big countries are using technology to control and utilize the methane emission to reduce the energy crisis. To decrease the coal mine injuries, academic understanding of underground methane management has increased, different technologies are integrated and support from various IT departments has amplified for the forecasting. In the future, the most critical task for coal mines risk assessment is to restore the worker's trust in mine safety, and the primary solution is to give more awareness to the underground management and workers through utilizing Artificial Intelligence (AI) mainly Artificial Neural Networks (ANN).

An Improved Artificial Potential Field Method for Ship Path Planning Based on Artificial Potential Field—Mined Customary Navigation Routes

In recent years, the artificial potential field has garnered significant attention in ship route planning and traffic flow simulation. However, the traditional artificial potential field method faces challenges in accurately simulating a ship’s customary route and navigating experience, leading to significant deviations in prediction results. To address these issues, in this study, we propose an innovative method for simulating and predicting ship traffic flow, building upon the artificial potential field approach. We introduce an AIS track heat map based on the kernel density function and enhance the artificial potential field model by incorporating factors, such as ship navigation habits and ship size. Through a comparison of traffic flow changes before and after the construction of a wind farm, the optimized model demonstrates its effectiveness in improving the accuracy of prediction results.

Language in Brains, Minds, and Machines.

It has long been argued that only humans could produce and understand language. But now, for the first time, artificial language models (LMs) achieve this feat. Here we survey the new purchase LMs are providing on the question of how language is implemented in the brain. We discuss why, a priori, LMs might be expected to share similarities with the human language system. We then summarize evidence that LMs represent linguistic information similarly enough to humans to enable relatively accurate brain encoding and decoding during language processing. Finally, we examine which LM properties-their architecture, task performance, or training-are critical for capturing human neural responses to language and review studies using LMs as in silico model organisms for testing hypotheses about language. These ongoing investigations bring us closer to understanding the representations and processes that underlie our ability to comprehend sentences and express thoughts in language.

Habitat Quality Analysis and Future Simulation Based on Artificial Neural Network-cellular Automata Model

Habitat Quality Analysis and Future Simulation Based on Artificial Neural Network-cellular Automata Model

Evaluating Biases and Quality Issues in Intermodality Image Translation Studies for Neuroradiology: A Systematic Review.

Intermodality image-to-image translation is an artificial intelligence technique for generating one technique from another. This review was designed to systematically identify and quantify biases and quality issues preventing validation and clinical application of artificial intelligence models for intermodality image-to-image translation of brain imaging. PubMed, Scopus, and IEEE Xplore were searched through August 2, 2023, for artificial intelligence-based image translation models of radiologic brain images. This review collected 102 works published between April 2017 and August 2023. Eligible studies were evaluated for quality using the Checklist for Artificial Intelligence in Medical Imaging (CLAIM) and for bias using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). Medically-focused article adherence was compared with that of engineering-focused articles overall with the Mann-Whitney U test and for each criterion using the Fisher exact test. Median adherence to the relevant CLAIM criteria was 69% and 38% for PROBAST questions. CLAIM adherence was lower for engineering-focused articles compared with medically-focused articles (65% versus 73%, P < .001). Engineering-focused studies had higher adherence for model description criteria, and medically-focused studies had higher adherence for data set and evaluation descriptions. Our review is limited by the study design and model heterogeneity. Nearly all studies revealed critical issues preventing clinical application, with engineering-focused studies showing higher adherence for the technical model description but significantly lower overall adherence than medically-focused studies. The pursuit of clinical application requires collaboration from both fields to improve reporting.

Implementation of artificial intelligence-based computer vision model in laparoscopic appendectomy: validation, reliability, and clinical correlation.

Application of artificial intelligence (AI) in general surgery is evolving. Real-world implementation of an AI-based computer-vision model in laparoscopic appendectomy (LA) is presented. We aimed to evaluate (1) its accuracy in complexity grading and safety adherence, (2) clinical correlation to outcomes. A retrospective single-center study of 499 consecutive LA videos, captured and analyzed by 'Surgical Intelligence Platform,' Theator Inc. (9/2020-5/2022). Two expert surgeons viewed all videos and manually graded complexity and safety adherence. Automated annotations were compared to surgeons' assessments. Inter-surgeons' agreements were measured. Since 7/2021 videos were linked to patients' admission numbers. Data retrieval from medical records was performed (n = 365). Outcomes were compared between high and low complexity grades. Low and high complexity grades comprised 74.8 and 25.2% of 499 videos. Surgeons' agreements were high (76.9-94.4%, kappa 0.77/0.91; p < 0.001) for all annotated complexity grades. Surgeons' agreements were also high (96.0-99.8%, kappa 0.78/0.87; p < 0.001) for full safety adherence, whereas agreement was moderate in partial safety adherence and none (32.8-58.8%). Inter-surgeons' agreements were high for complexity grading (kappa 0.86, p < 0.001) and safety adherence (kappa 0.88, p < 0.001). Comparing high to low grade complexity, preoperative clinical features were similar, except larger appendix diameter on imaging (13.4 ± 4.4 vs. 10.5 ± 3.0mm, p < 0.001). Intraoperative outcomes were significantly higher (p < 0.001), including time to achieve critical view of safety (29.6, IQR 19.1-41.6 vs. 13.7, IQR 8.5-21.1min), operative duration (45.3, IQR 37.7-65.2 vs. 25.0, IQR 18.3-32.7min), and intraoperative events (39.4% vs. 5.9%). Postoperative outcomes (7.4% vs. 9.2%) including surgical complications, mortality, and readmissions were comparable (p = 0.6), except length of stay (4, IQR 2-5.5 vs. 1, IQR1-2days; p < 0.001). The model accurately assesses complexity grading and full safety achievement. It can serve to predict operative time and intraoperative course, whereas no clinical correlation was found regarding postoperative outcomes. Further studies are needed.