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PubMed2026

Artificial Intelligence for Colorectal Surgeons-Part II: Research Applications, Challenges in Adoption, and Practical Resources.

BACKGROUND: This is part II of a 2-part series examining artificial intelligence in colorectal surgery. Part I established foundational concepts and clinical applications. Implementation, however, requires understanding research methodologies, available resources, and the specific challenges currently limiting widespread adoption. These topics are the focus of part II. OBJECTIVE: To examine artificial intelligence's transformation of surgical research, provide practical implementation resources, address adoption challenges, and explore future directions in colorectal surgery. METHODS: Comprehensive literature review focusing on artificial intelligence research methodology, implementation barriers, educational resources, and emerging technologies relevant to colorectal surgeons. RESULTS: Artificial intelligence streamlines clinical trial design through predictive modeling and natural language processing, reducing enrollment challenges that contribute to failed or inadequate trial accrual. Machine learning enables heterogeneity analysis within clinical trials, identifying treatment-responsive subgroups. Foundation models unlock analysis of unstructured electronic health record data at scale. Professional societies and universities offer specialized artificial intelligence education programs, with open-access data sets facilitating research participation. However, implementation faces multifaceted challenges: technical infrastructure demands, with real-time processing requiring dedicated graphics processing unit clusters; regulatory frameworks struggling with continuously evolving algorithms; undefined liability distribution for artificial intelligence-assisted decisions; algorithmic bias risking health care disparities; and the "black box" problem limiting clinical trust. Economic barriers include substantial initial costs without clear reimbursement pathways. Future directions include multimodal artificial intelligence integrating imaging, genomics, and histopathology; cognitive robotic systems with real-time decision support; digital twin technology for patient-specific surgical simulation; and global surgical artificial intelligence networks enabling distributed learning across institutions. CONCLUSIONS: Although artificial intelligence offers transformative potential for colorectal surgery research and practice, successful implementation requires addressing technical, regulatory, ethical, and economic challenges. The surgeon's evolving role demands both traditional expertise and computational fluency. Future advances in multimodal integration, autonomous systems, and global collaboration will fundamentally reshape surgical practice but will require thoughtful implementation prioritizing patient benefit and clinical value.

Humans↗
PubMed2004

Use of artificial intelligence to identify cardiovascular compromise in a model of hemorrhagic shock.

OBJECTIVE: To determine whether a prototype artificial intelligence system can identify volume of hemorrhage in a porcine model of controlled hemorrhagic shock. DESIGN: Prospective in vivo animal model of hemorrhagic shock. SETTING: Research foundation animal surgical suite; computer laboratories of collaborating industry partner. SUBJECTS: Nineteen, juvenile, 25- to 35-kg, male and female swine. INTERVENTIONS: Anesthetized animals were instrumented for arterial and systemic venous pressure monitoring and blood sampling, and a splenectomy was performed. Following a 1-hr stabilization period, animals were hemorrhaged in aliquots to 10, 20, 30, 35, 40, 45, and 50% of total blood volume with a 10-min recovery between each aliquot. Data were downloaded directly from a commercial monitoring system into a proprietary PC-based software package for analysis. MEASUREMENTS AND MAIN RESULTS: Arterial and venous blood gas values, glucose, and cardiac output were collected at specified intervals. Electrocardiogram, electroencephalogram, mixed venous oxygen saturation, temperature (core and blood), mean arterial pressure, pulmonary artery pressure, central venous pressure, pulse oximetry, and end-tidal CO(2) were continuously monitored and downloaded. Seventeen of 19 animals (89%) died as a direct result of hemorrhage. Stored data streams were analyzed by the prototype artificial intelligence system. For this project, the artificial intelligence system identified and compared three electrocardiographic features (R-R interval, QRS amplitude, and R-S interval) from each of nine unknown samples of the QRS complex. We found that the artificial intelligence system, trained on only three electrocardiographic features, identified hemorrhage volume with an average accuracy of 91% (95% confidence interval, 84-96%). CONCLUSIONS: These experiments demonstrate that an artificial intelligence system, based solely on the analysis of QRS amplitude, R-R interval, and R-S interval of an electrocardiogram, is able to accurately identify hemorrhage volume in a porcine model of lethal hemorrhagic shock. We suggest that this technology may represent a noninvasive means of assessing the physiologic state during and immediately following hemorrhage. Point of care application of this technology may improve outcomes with earlier diagnosis and better titration of therapy of shock.

Animals↗
PubMed2005

Tissue engineering scheming by artificial intelligence.

Tissue engineers are often confused when seeking the most effective, economical and secure scheme for tissue engineering. The aim of this study is to generate tissue engineering schemes with artificial intelligence instead of human intelligence. The experimental data of tissue engineered cartilage were integrated and standardized with a centralized database, and a scheme engine was developed using artificial intelligent methods (artificial neural networks and decision trees). The scheme engine was trained with existing cases in the database, and then was used to generate tissue engineering schemes for new experimental animals. Following the schemes generated by the artificial intelligent system, we cured 18 of the 20 experimental animals. In conclusion, artificial intelligence is a powerful method for decision making in the tissue engineering realm.

Algorithms↗
PubMed2026

Artificial Intelligence Technologies in Nursing Clinical Decision-Making: An Umbrella Review.

AIM: To describe contemporary peer-reviewed literature on artificial intelligence in nurses' clinical decision-making. METHODS: An umbrella review of literature reviews. DATA SOURCES: Four major databases were searched for reviews published between 2019 and 2024. RESULTS: Sixteen literature reviews reported on 965 nursing artificial intelligence primary studies. The studies focused on technology development and emerging performance evaluations, whilst real-world testing or implementation in nursing clinical settings was rare. Rigorous comparative analyses were lacking. While artificial intelligence demonstrates promise in decision-making, challenges such as a lack of controlled studies, algorithmic bias, limited reproducibility and insufficient clinical trials hinder its practical impact. Ethical concerns, transparency and patient data privacy issues pose barriers to AI integration in nursing practice. Ethical and legal guidelines for patient privacy are needed and should be taught along with AI literacy training for nurses. CONCLUSIONS: Artificial intelligence has the potential to enhance clinical nursing decision-making, although evidence is limited by too few examples of nurse participation during development. Underutilisation in administrative nursing functions hinders implementation. Nurses should assume a central role in the design and development of AI applications to ensure that these technologies address the realities of nursing practice. With such improvements, artificial intelligence can transform nursing practice, improve nurses' clinical decision-making and ultimately enhance consumer healthcare outcomes. PATIENT OR PUBLIC INVOLVEMENT: No Patient or Public Involvement. REPORTING METHOD: While there is no reporting checklist for umbrella reviews, the PRISMA guide for systematic reviews was followed.

Artificial Intelligence↗
PubMed1992

Application of artificial intelligence to pharmacy and medicine.

Artificial intelligence (AI) is a branch of computer science dealing with solving problems using symbolic programming. It has evolved into a problem solving science with applications in business, engineering, and health care. One application of AI is expert system development. An expert system consists of a knowledge base and inference engine, coupled with a user interface. A crucial aspect of expert system development is knowledge acquisition and implementing computable ways to solve problems. There have been several expert systems developed in medicine to assist physicians with medical diagnosis. Recently, several programs focusing on drug therapy have been described. They provide guidance on drug interactions, drug therapy monitoring, and drug formulary selection. There are many aspects of pharmacy that AI can have an impact on and the reader is challenged to consider these possibilities because they may some day become a reality in pharmacy.

Artificial Intelligence↗
PubMed1999

Levels and loops: the future of artificial intelligence and neuroscience.

In discussing artificial intelligence and neuroscience, I will focus on two themes. The first is the universality of cycles (or loops): sets of variables that affect each other in such a way that any feed-forward account of causality and control, while informative, is misleading. The second theme is based around the observation that a computer is an intrinsically dualistic entity, with its physical set-up designed so as not to interfere with its logical set-up, which executes the computation. The brain is different. When analysed empirically at several different levels (cellular, molecular), it appears that there is no satisfactory way to separate a physical brain model (or algorithm, or representation), from a physical implementational substrate. When program and implementation are inseparable and thus interfere with each other, a dualistic point-of-view is impossible. Forced by empiricism into a monistic perspective, the brain-mind appears as neither embodied by or embedded in physical reality, but rather as identical to physical reality. This perspective has implications for the future of science and society. I will approach these from a negative point-of-view, by critiquing some of our millennial culture's popular projected futures.

Artificial Intelligence↗
PubMed2026

A systematic approach to standardizing the visual appearance of endometriotic lesions for artificial intelligence recognition.

INTRODUCTION: Numerous studies have shown that the diagnostic performance and reproducibility of visual recognition of endometriosis during laparoscopy are poor. The use of artificial intelligence (AI) seems relevant for exhaustive lesion recognition. Standardization of the visual classification of lesions, in the form of an ontology, is an essential prerequisite to enable medical experts to annotate surgical data consistently and subsequently allow engineers to train and build an artificial intelligence tool for endometriosis recognition. MATERIAL AND METHODS: A systematic search was conducted in the MEDLINE (via PubMed), EMBASE, and the Cochrane Library databases up to May 2022, aiming to identify studies describing the laparoscopic visual appearance of superficial endometriosis, endometriomas, and deep infiltrating endometriosis. The accumulated data in the literature concerning the visual appearance of the different forms of endometriosis were used to create an ontology that could be used for artificial intelligence applications. RESULTS: Out of 932 articles screened, 35 studies were selected based on the inclusion criteria of human subjects with histologically confirmed endometriosis lesions visualized via laparoscopy. The selected studies were reviewed to develop a visual ontology of endometriosis lesions observed via laparoscopy. The lesions were categorized into 4 classes and further subdivided into 11 subclasses: superficial (black, red, white, or subtle), adhesions (dense or filmy), deep (obliteration, retraction, or deformation), and ovarian (endometrioma or chocolate fluid). The positive predictive value (PPV) varied across lesion types: black lesions (PPV 47%-97%), red lesions (PPV 33%-100%), white lesions (PPV 20%-81%), and ovarian endometriosis (PPV 42%-98%). Nonspecific lesions such as adhesions (PPV 16%-50%) and subtle superficial lesions (PPV 0%-67%) presented lower PPVs. Deep endometriosis lesions, often buried within organs, required indirect signs (obliteration, retraction, deformation) for identification. CONCLUSIONS: The visual ontology proposed in this systematic search could facilitate the detection and classification of endometriosis lesions using artificial intelligence. This study highlights the challenges of reaching a consensus on lesion recognition and classification in AI projects due to the diverse visual presentations of endometriosis.

Humans↗
PubMed1990

Laboratory robotics and artificial intelligence.

Intelligent robots, which incorporate artificial intelligence in their controlling software, are the next step in bringing the laboratory robot to its full potential. The areas currently under study in our laboratory are improved user interfaces for laboratory robotics, the integration of object-oriented databases into robot control programs, and strategies to optimize multi-step procedures. The ultimate goal of this work is the Standard Robotics Method. The Standard Robotics Method we envision would allow a robotic method to be transferred from one laboratory to another.

Artificial Intelligence↗
PubMed1995

Use of artificial intelligence in analytical systems for the clinical laboratory.

OBJECTIVE: To consider the role of software in system operation, control and automation, and attempts to define intelligence. METHODS AND RESULTS: Artificial intelligence (Al) is characterized by its ability to deal with incomplete and imprecise information and to accumulate knowledge. Expert systems, building on standard computing techniques, depend heavily on the domain experts and knowledge engineers that have programmed them to represent the real world. Neural networks are intended to emulate the pattern-recognition and parallel processing capabilities of the human brain and are taught rather than programmed. The future may lie in a combination of the recognition ability of the neural network and the rationalization capability of the expert system. In the second part of this paper, examples are given of applications of Al in stand-alone systems for knowledge engineering and medical diagnosis and in embedded systems for failure detection, image analysis, user interfacing, natural language processing, robotics and machine learning, as related to clinical laboratories. CONCLUSION: Al constitutes a collective form of intellectual property, and that there is a need for better documentation, evaluation and regulation of the systems already being used widely in clinical laboratories.

Artificial Intelligence↗
PubMed2001

Artificial intelligence: the clinician of the future.

Human beings have long been fascinated with the idea of artificial intelligence. This fascination is fueled by popular films such as Stanley Kubrick's 2001: A Space Odyssey and Stephen Spielberg's recent film, AI. However intriguing artificial intelligence may be, Hubert and Spencer Dreyfus contend that qualities exist that are uniquely human--the qualities thought to be inaccessible to the computer "mind." Patricia Benner further investigated the qualities that guide clinicians in making decisions and assessments that are not entirely evidence-based or grounded in scientific data. Perhaps it is the intuitive nature of the human being that separates us from the machine. The state of artificial intelligence is described herein, along with a discussion of computerized clinical decision-making and the role of the human being in these decisions.

Artificial Intelligence↗
PubMed2001

Artificial intelligence applications in the intensive care unit.

OBJECTIVE: To review the history and current applications of artificial intelligence in the intensive care unit. DATA SOURCES: The MEDLINE database, bibliographies of selected articles, and current texts on the subject. STUDY SELECTION: The studies that were selected for review used artificial intelligence tools for a variety of intensive care applications, including direct patient care and retrospective database analysis. DATA EXTRACTION: All literature relevant to the topic was reviewed. DATA SYNTHESIS: Although some of the earliest artificial intelligence (AI) applications were medically oriented, AI has not been widely accepted in medicine. Despite this, patient demographic, clinical, and billing data are increasingly available in an electronic format and therefore susceptible to analysis by intelligent software. Individual AI tools are specifically suited to different tasks, such as waveform analysis or device control. CONCLUSIONS: The intensive care environment is particularly suited to the implementation of AI tools because of the wealth of available data and the inherent opportunities for increased efficiency in inpatient care. A variety of new AI tools have become available in recent years that can function as intelligent assistants to clinicians, constantly monitoring electronic data streams for important trends, or adjusting the settings of bedside devices. The integration of these tools into the intensive care unit can be expected to reduce costs and improve patient outcomes.

Algorithms↗
PubMed1998

[Leukocyte differentiation by MICRO21 system using neural networking as a type of artificial intelligence].

NeuralVision is a type of artificial intelligence that has the ability to identify specific microscopic objects. The MICRO21 system uses neural networking to analyze the features of blood cells; color, shape, size, and density, just as a technologist would. The basic nucleated blood cell processing procedure of the MICRO21 is divided into three general categories; location, segmentation, and classification. Classification takes place using the Neural Network and is fine tuned during post-processing. We evaluated the performance of the MICRO21 automated differential vs. manual differential method. The intra-assay of leukocyte differentiation by MICRO21 was fairly good in normal samples with normal leukocyte counts. The neutrophils, lymphocytes and eosinophils count correlated well between MICRO21 and visual count. Post-processing was performed after the Neural Network has initially classified the cell, in which the confidence levels of MICRO21 to visual count was 87%. By post-processing, coincidence ratio of cell-by-cell by MICRO21 and visual count has been improved to 97%. Based on the above, MICRO21 is an effective and efficient system for locating, storing and displaying images of white blood cells, in which the technologist could determine specific characteristics of cells in each laboratory. Furthermore, the system may be applied to any blood cell and would be important from the perspective of cytological and morphological analysis, such as blood cells in bone marrow and body fluid, in the future.

Artificial Intelligence↗
PubMedDate not supplied

Artificial intelligence in medicine: the challenges ahead.

The modern study of artificial intelligence in medicine (AIM) is 25 years old. Throughout this period, the field has attracted many of the best computer scientists, and their work represents a remarkable achievement. However, AIM has not been successful-if success is judged as making an impact on the practice of medicine. Much recent work in AIM has been focused inward, addressing problems that are at the crossroads of the parent disciplines of medicine and artificial intelligence. Now, AIM must move forward with the insights that it has gained and focus on finding solutions for problems at the heart of medical practice. The growing emphasis within medicine on evidence-based practice should provide the right environment for that change.

Artificial Intelligence↗
PubMed1990

Artificial intelligence for medical decision making.

Artificial intelligence techniques find extensive applications in medical decision making and other aspects of health care. A number of successful expert systems have been developed in various disciplines of medicine. This paper gives an overview of expert system techniques, describes some practical systems, and discusses the relevance of such systems in clinical diagnosis and management of diseases.

Decision Making, Computer-Assisted↗
PubMed1996

Application of an artificial intelligence program to therapy of high-risk surgical patients.

We developed an artificial intelligence program from a large computerized database of hemodynamic and oxygen transport measurements together with prior studies defining survivors' values, outcome predictors, and a branched-chain decision tree. The artificial intelligence program was then tested on the data of 100 survivors and 100 nonsurvivors not used for the development of the program or other analyses. Using the predictor as a surrogate outcome measure, the therapy recommended by the program improved the predicted outcome 3.16% per therapeutic intervention while the actual therapy given increased outcome 1.86% in surviving patients; the artificial intelligence-recommended therapy improved outcome 7.9% in nonsurvivors, while the actual therapy given increased predicted outcome -0.29% in nonsurvivors (p < .05). There were fewer patients whose predicted outcome decreased after recommended treatment (14%) than after the actual therapy given (37%). Review of therapy recommended by the program did not reveal instances of inappropriate or potentially harmful recommendations.

Artificial Intelligence↗
PubMed2002

[The application and development of artificial intelligence in medical diagnosis systems].

This paper has reviewed the development of artificial intelligence in medical practice and medical diagnostic expert systems, and has summarized the application of artificial neural network. It explains that a source of difficulty in medical diagnostic system is the co-existence of multiple diseases--the potentially inter-related diseases. However, the difficulty of image expert systems is inherent in high-level vision. And it increases the complexity of expert system in medical image. At last, the prospect for the development of artificial intelligence in medical image expert systems is made.

Artificial Intelligence↗
PubMed1990

Teachers and artificial intelligence. The Logo connection.

This article describes a three-phase program for training special education teachers to teach Logo and artificial intelligence. Logo is derived from the LISP computer language and is relatively simple to learn and use, and it is argued that these factors make it an ideal tool for classroom experimentation in basic artificial intelligence concepts. The program trains teachers to develop simple demonstrations of artificial intelligence using Logo. The material that the teachers learn to teach is suitable as an advanced level topic for intermediate- through secondary-level students enrolled in computer competency or similar courses. The material emphasizes problem-solving and thinking skills using a nonverbal expressive medium (Logo), thus it is deemed especially appropriate for hearing-impaired children. It is also sufficiently challenging for academically talented children, whether hearing or deaf. Although the notion of teachers as programmers is controversial, Logo is relatively easy to learn, has direct implications for education, and has been found to be an excellent tool for empowerment-for both teachers and children.

Artificial Intelligence↗
PubMed2026

Generative artificial intelligence for enzyme design and biocatalysis.

Sparked by innovations in generative artificial intelligence (AI), the field of protein design has undergone a paradigm shift with an explosion of new models for optimizing existing enzymes or creating them from scratch. After more than one decade of low success rates for computationally designed enzymes, generative AI models are now frequently used for designing proficient enzymes. Here, we provide a comprehensive overview and classification of generative AI models for enzyme design, highlighting models with experimental validation relevant to real-world settings and outlining their respective limitations. We argue that generative AI models now have the maturity to create and optimize enzymes for industrial applications. Wider adoption of generative AI models with experimental feedback loops can speed up the development of biocatalysts and serve as a community assessment to inform the next generation of models.

Biocatalysis↗