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The attributes of medical event-reporting systems: experience with a prototype medical event-reporting system for transfusion medicine.

OBJECTIVE: To design, develop, and implement a prototype medical event-reporting system for use in transfusion medicine to improve transfusion safety by studying incidents and errors. METHODS: The IDEALS concept of design was used to identify specifications for the event-reporting system, and a Delphi and subsequent nominal group technique meetings were used to reach consensus on the development of the system. An interdisciplinary panel of experts from aviation safety, nuclear power, cognitive psychology, artificial intelligence, and education and representatives of major transfusion medicine organizations participated in the development process. Setting.- Three blood centers and three hospital transfusion services implemented the reporting system. RESULTS: A working prototype event-reporting system was recommended and implemented. The system has seven components: detection, selection, description, classification, computation, interpretation, and local evaluation. Its unique features include no-fault reporting initiated by the individual discovering the event, who submits a report that is investigated by local quality assurance personnel and forwarded to a nonregulatory central system for computation and interpretation. CONCLUSIONS: An event-reporting system incorporated into present quality assurance and risk management efforts can help organizations address system structural and procedural weakness where the potential for errors can adversely affect health care outcomes. Input from the end users of the system as well as from external experts should enable this reporting system to serve as a useful model for others who may develop event-reporting systems in other medical domains.

Blood Transfusion↗

Modeling treatment of ischemic heart disease with partially observable Markov decision processes.

Diagnosis of a disease and its treatment are not separate, one-shot activities. Instead they are very often dependent and interleaved over time, mostly due to uncertainty about the underlying disease, uncertainty associated with the response of a patient to the treatment and varying cost of different diagnostic (investigative) and treatment procedures. The framework of Partially observable Markov decision processes (POMDPs) developed and used in operations research, control theory and artificial intelligence communities is particularly suitable for modeling such a complex decision process. In the paper, we show how the POMDP framework could be used to model and solve the problem of the management of patients with ischemic heart disease, and point out modeling advantages of the framework over standard decision formalisms.

Decision Support Techniques↗

User Engagement and Feature Preferences in an AI-Powered mHealth Intervention for Diabetes Prevention: Secondary Analysis of a Randomized Controlled Trial.

BACKGROUND: Prediabetes is highly prevalent and increasing globally, yet lifestyle interventions remain underused. AI-driven mobile health (mHealth) tools can help scale diabetes prevention efforts, but the key factors driving their success are not well understood. OBJECTIVE: This post hoc secondary analysis of a randomized controlled trial (RCT) aimed to characterize the most valued features and the role of user engagement in outcomes of a fully automated mHealth intervention for diabetes prevention. METHODS: Data from 151 participants with prediabetes and overweight or obesity who were assigned to an AI-based diabetes prevention program (Sweetch) in a parent RCT (NCT05056376) were analyzed. Engagement (defined as the total number of days the app was used) was categorized into tertiles (low, medium, and high). Baseline characteristics were compared across engagement groups using ANOVA, Kruskal-Wallis, and chi-square tests, and regression models assessed the association between engagement and achievement of diabetes risk reduction outcomes (&#x2265;5% weight loss, &#x2265;4% weight loss with &#x2265;150 min/week of physical activity, or &#x2265;0.2 percentage point reduction in hemoglobin A1c [HbA1c] at 12 months). Perceived usefulness of intervention features was surveyed at 12 months. RESULTS: Median engagement was 98 (IQR 34-232) days. Older age (P<.001) and lower baseline BMI (P=.04) were significantly associated with higher engagement. Compared with low engagement, high engagement was associated with greater odds of achieving the composite diabetes risk reduction outcome (odds ratio [OR] 2.59, 95% CI 1.11-6.01; P=.03), &#x2265;5% weight loss (OR 3.31, 95% CI 1.16-9.42; P=.03), and &#x2265;0.2 percentage point reduction in HbA1c (OR 3.57, 95% CI 1.19-10.75; P=.02). Participants most frequently rated weight tracking, physical activity tracking, and the digital body weight scale as the features that were most helpful for achieving their health goals. CONCLUSIONS: Higher engagement with an AI-driven intervention requiring no human intervention was associated with improved diabetes risk reduction. Contrary to concerns about lower digital literacy, older adults engaged with the intervention more than younger adults. Features related to weight and physical activity tracking were most valued by patients in the program. TRIAL REGISTRATION: ClinicalTrials.gov NCT05056376; https://clinicaltrials.gov/study/NCT05056376.

Humans↗

An intelligent sales forecasting system through integration of artificial neural networks and fuzzy neural networks with fuzzy weight elimination.

Sales forecasting plays a very prominent role in business strategy. Numerous investigations addressing this problem have generally employed statistical methods, such as regression or autoregressive and moving average (ARMA). However, sales forecasting is very complicated owing to influence by internal and external environments. Recently, artificial neural networks (ANNs) have also been applied in sales forecasting since their promising performances in the areas of control and pattern recognition. However, further improvement is still necessary since unique circumstances, e.g. promotion, cause a sudden change in the sales pattern. Thus, this study utilizes a proposed fuzzy neural network (FNN), which is able to eliminate the unimportant weights, for the sake of learning fuzzy IF-THEN rules obtained from the marketing experts with respect to promotion. The result from FNN is further integrated with the time series data through an ANN. Both the simulated and real-world problem results show that FNN with weight elimination can have lower training error compared with the regular FNN. Besides, real-world problem results also indicate that the proposed estimation system outperforms the conventional statistical method and single ANN in accuracy.

Algorithms↗

Performance of AI-Based Screening Tools for Obstructive Sleep Apnea Across Apnea-Hypopnea Index Thresholds: Systematic Review and Meta-Analysis.

BACKGROUND: Obstructive sleep apnea (OSA) is highly prevalent but remains substantially underdiagnosed. Polysomnography (PSG) is the reference standard, but its cost and limited availability constrain large-scale case identification. AI-based screening tools may support risk stratification and referral prioritization, but their diagnostic accuracy across apnea-hypopnea index (AHI) thresholds remains uncertain. OBJECTIVE: This review aimed to systematically evaluate the diagnostic accuracy of AI-based OSA screening tools at AHI thresholds of &#x2265;5, &#x2265;15, and &#x2265;30 events/hour, with emphasis on models using non-PSG-derived inputs. METHODS: PubMed, Embase, Scopus, and Web of Science were searched for studies published from January 1, 2016, to May 3, 2026. Eligible studies included adults evaluated for suspected OSA or recruited from population-based cohorts, assessed AI-based models intended or interpretable for OSA screening, risk prediction, or screening-oriented severity classification, used PSG as the reference standard, and reported sufficient data to construct or reconstruct 2&#xd7;2 contingency tables. Diagnostic accuracy was synthesized separately by AHI threshold and input source using bivariate random-effects models, with 95% CIs and prediction intervals (PIs). Risk of bias and certainty of evidence were assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) and GRADE (Grading of Recommendations Assessment, Development, and Evaluation), respectively. RESULTS: A total of 60 studies were included, of which 47 contributed data to the meta-analysis. At AHI thresholds of &#x2265;5, &#x2265;15, and &#x2265;30 events/hour, pooled sensitivities were 0.94 (95% CI 0.92-0.96; 95% PI 0.71-0.99), 0.87 (95% CI 0.84-0.89; 95% PI 0.66-0.96), and 0.83 (95% CI 0.79-0.87; 95% PI 0.61-0.94), respectively; the corresponding specificities were 0.77 (95% CI 0.69-0.84; 95% PI 0.30-0.96), 0.81 (95% CI 0.75-0.85; 95% PI 0.39-0.96), and 0.91 (95% CI 0.87-0.94; 95% PI 0.55-0.99), respectively. The corresponding areas under the summary receiver operating characteristic curves were 0.943, 0.907, and 0.920. For non-PSG-derived tools, sensitivities were 0.92, 0.85, and 0.81, and specificities were 0.70, 0.74, and 0.85 at the 3 thresholds, respectively. For PSG-derived models, sensitivities were 0.96, 0.90, and 0.85, and specificities were 0.82, 0.88, and 0.96, respectively. Exploratory subgroup analyses suggested performance variation across selected study and model characteristics, including region, algorithmic framework, data source, and validation method. CONCLUSIONS: AI-based tools showed generally favorable screening performance for OSA across clinically relevant AHI thresholds, although wide PIs suggest variable performance across future comparable populations and settings. By synthesizing diagnostic accuracy across 3 AHI thresholds and distinguishing non-PSG-derived from PSG-derived models, this review extends previous broad or modality-specific reviews and offers a clinically interpretable, pathway-specific basis for linking model performance to intended use. The findings may clarify potential roles for non-PSG-derived tools in front-end screening and referral prioritization and for PSG-derived models in reduced-channel assessment and sleep-laboratory workflow support. Given substantial heterogeneity, limited external validation, and low or very low certainty of evidence, prospective validation is needed before routine implementation.

Humans↗

Comparative Efficacy of Different AI Systems for Polyp Detection by Size During Colonoscopy: Systematic Review and Network Meta-Analysis.

BACKGROUND: Colorectal cancer remains a leading cause of death despite being largely preventable through polypectomy. AI systems designed to enhance polyp detection during colonoscopy have shown promise, but the extent to which they improve detection of different-sized polyps remains unclear. OBJECTIVE: This study compared the size-stratified efficacy of AI-assisted colonoscopy vs standard colonoscopy using the Hartung-Knapp-Sidik-Jonkman (HKSJ) method, and generated exploratory rankings while acknowledging all cross-platform comparisons are indirect. METHODS: This systematic review and network meta-analysis (NMA) searched PubMed, Embase, Cochrane CENTRAL, and Web of Science from inception to July 25, 2026, supplemented by citation searching. We included randomized controlled trials (RCTs) comparing AI-assisted vs standard colonoscopy in adults (&#x2265;18 years of age), reporting mean polyp detection counts stratified by size (&#x2264;5 mm, 6-9 mm, and &#x2265;10 mm). Two reviewers screened studies, extracted data, and assessed risk of bias using the Cochrane Risk of Bias 2.0. We conducted frequentist NMA using the HKSJ method with restricted maximum likelihood estimation, calculated 95% prediction intervals (PIs), and assessed heterogeneity using I2 and &#x3c4;2. Certainty of evidence was rated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework. RESULTS: A total of 13 RCTs (4156 participants) compared 8 AI systems to standard colonoscopy, forming a network without direct AI comparisons. For diminutive polyps (&#x2264;5 mm), AI showed a modest advantage (standardized mean difference [SMD] 0.21, 95% CI 0.07 to 0.35, 95% PI -1.12 to 1.54), but substantial heterogeneity (I2=86.6%) and wide PI crossing the null indicated high uncertainty. EndoScreener showed the most consistent evidence (SMD 0.36, 95% CI 0.18-0.54). For small and large polyps, effects were minimal (SMD 0.02, 95% CI -0.02 to 0.06, 95% PI -0.03 to 0.07; SMD 0.01, 95% CI 0.00-0.02, 95% PI -0.01 to 0.03). GRADE certainty was very low for diminutive polyps and low for small and large polyps. Sensitivity analysis excluding Tianjin YuJin did not materially change findings. CONCLUSIONS: AI may modestly enhance diminutive polyp detection, but effects on small and large polyps are minimal, with no platform superiority. Given very low to low certainty, findings are hypothesis-generating. This exploratory NMA provides size-stratified comparisons that can inform future head-to-head trial design. Unlike prior reviews aggregating all polyp sizes, we show the overall AI benefit is driven by diminutive polyp detection, providing a framework for targeted deployment-prioritizing AI for diminutive polyp screening, with limited value for larger lesions. Head-to-head trials are urgently needed. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD420251266932; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251266932.

Colonoscopy↗

AI-generated familiarity estimates are a useful new source of information about word knowledge in Simplified Chinese.

This study evaluated the usefulness of AI-generated estimates of word familiarity for predicting word difficulty in Simplified Chinese, building on previous research in alphabetic languages. We found that familiarity estimates produced using large language models (LLMs) showed moderate-to-strong correlations with human familiarity ratings. These LLM estimates were the most effective predictors of both word naming and lexical decision times, surpassing traditional metrics such as word frequency and human familiarity ratings, while the latter still provided modest, non-overlapping variance. GPT-4o with English instructions produced superior results compared to the Chinese-centered models currently available. The results imply that LLM familiarity estimates are a valuable resource for Chinese psycholinguistics, supporting work across experimental design, modeling, and norming. We release familiarity estimates for 27,624 words for unrestricted research and educational use.

Humans↗

Individual speaker influence on relative intelligibility of esophageal speech and artificial larynx speech.

Comparisons were made of the relative intelligibility of esophageal and artificial larynx speech. Care was taken to minimize the variable effects of individual speaker characteristics. For example, rather than relying solely on data comparisons between groups of different speakers, contrasts were also made between samples from subjects who could use both means of alaryngeal speech. Fifteen proficient male laryngectomized speakers were selected. Five used only esophageal speech, five used only artificial larynx speech, and five produced both forms of speech. Recordings were made while the subjects read 50 PB (Phonetically Balanced) words embedded in a carrier phrase and were transcribed by 30 naive listeners. Differences in intelligibility between esophageal and artificial larynx speech resulted when data comparisons were based on different speaker groups. However, differences were not evident when data from the same speakers were compared. The results were interpreted to highlight the possible influence of individual speaker characteristics, rather than differences between communication methods.

Humans↗

New robotics: design principles for intelligent systems.

New robotics is an approach to robotics that, in contrast to traditional robotics, employs ideas and principles from biology. While in the traditional approach there are generally accepted methods (e. g., from control theory), designing agents in the new robotics approach is still largely considered an art. In recent years, we have been developing a set of heuristics, or design principles, that on the one hand capture theoretical insights about intelligent (adaptive) behavior, and on the other provide guidance in actually designing and building systems. In this article we provide an overview of all the principles but focus on the principles of ecological balance, which concerns the relation between environment, morphology, materials, and control, and sensory-motor coordination, which concerns self-generated sensory stimulation as the agent interacts with the environment and which is a key to the development of high-level intelligence. As we argue, artificial evolution together with morphogenesis is not only "nice to have" but is in fact a necessary tool for designing embodied agents.

Artificial Intelligence↗

An AI-assisted Clinical Decision Support System for Green Classification of Cystocele on Dynamic Transperineal Ultrasound.

Green classification of cystocele on dynamic transperineal ultrasound (TPUS) remains operator-dependent because it requires manual frame selection and landmark-based assessment of the Valsalva maneuver. We developed a workflow-oriented AI-assisted clinical decision support system for automated urethrovesical junction localization and dynamic Green classification and prospectively evaluated its standalone and reader-support performance. This diagnostic accuracy and reader study included 881 patients from a tertiary referral hospital, comprising a retrospective development cohort (n&#x2009;=&#x2009;688) and an independent prospective test cohort (n&#x2009;=&#x2009;193). A nested subset of 67 prospective patients was used for a reader study involving two junior and two intermediate radiologists under unaided and AI-assisted conditions. In the complete prospective test cohort, Green-AttGRU achieved a macro-averaged AUC of 0.939 (95% CI, 0.897-0.971) and an overall accuracy of 0.902 (95% CI, 0.860-0.943). In the reader study, overall accuracy increased from 0.761 to 0.821 without AI to 0.851-0.881 with AI, while macro-F1 increased from 0.660 to 0.777 to 0.820-0.860. Overall inter-reader agreement increased from a Fleiss' &#x3ba; of 0.453 to 0.786, and pooled median interpretation time decreased from 26.7&#xa0;s to 9.9&#xa0;s. These findings support the preliminary feasibility of the system as a workflow-oriented decision-support tool for dynamic TPUS interpretation.

Humans↗

How AI Is Speeding Up the Diagnostic Odyssey for Rare Diseases.

The road to diagnosis can be long and sometimes unending for rare diseases, requiring training and resources that many clinics do not have. In this News and Perspectives article, JMIR Correspondent Simon Spichak reports on how AI initiatives at a children's hospital in the United States and one in Canada are helping bridge that gap and could fundamentally reshape the diagnostic experience for children and families living with rare diseases.

Rare Diseases↗

An intelligent remote monitoring system for artificial heart.

A web-based database system for intelligent remote monitoring of an artificial heart has been developed. It is important for patients with an artificial heart implant to be discharged from the hospital after an appropriate stabilization period for better recovery and quality of life. Reliable continuous remote monitoring systems for these patients with life support devices are gaining practical meaning. The authors have developed a remote monitoring system for this purpose that consists of a portable/desktop monitoring terminal, a database for continuous recording of patient and device status, a web-based data access system with which clinicians can access real-time patient and device status data and past history data, and an intelligent diagnosis algorithm module that noninvasively estimates blood pump output and makes automatic classification of the device status. The system has been tested with data generation emulators installed on remote sites for simulation study, and in two cases of animal experiments conducted at remote facilities. The system showed acceptable functionality and reliability. The intelligence algorithm also showed acceptable practicality in an application to animal experiment data.

Decision Support Systems, Clinical↗

Integrating expert knowledge into large language models improves performance for psychiatric reasoning and diagnosis.

BACKGROUND AND METHODS: The authors sought to evaluate the performance of common large language models (LLMs) in psychiatric diagnosis, and the impact of integrating expert-derived reasoning on their performance. Clinical case vignettes and associated diagnoses were retrieved from the DSM-5-TR Clinical Cases book. Diagnostic decision trees were retrieved from the DSM-5-TR Handbook of Differential Diagnosis and refined for LLM use. Three LLMs were prompted to provide diagnosis candidates for the vignettes either by directly prompting or using the decision trees. These candidates and diagnostic categories were compared against the correct diagnoses. The positive predictive value (PPV), sensitivity, and F1 statistic were used to measure performance. RESULTS: When directly prompted to predict diagnoses, the best LLM by F1 statistic (gpt-4o) had sensitivity of 76.7 % and PPV of 40.4 %. When making use of the refined decision trees, PPV was significantly increased (65.3 %) without a significant reduction in sensitivity (70.9 %). Across all experiments, the use of the decision trees statistically significantly increased the PPV, significantly increased the F1 statistic in 5/6 experiments, and significantly reduced sensitivity in 4/6 experiments. DISCUSSION: When used to predict psychiatric diagnoses from case vignettes, direct prompting of the LLMs yielded most true positive diagnoses but had significant overdiagnosis. Integrating expert-derived reasoning into the process using decision trees improved LLM performance (as measured by F1 statistic), primarily by suppressing overdiagnosis with a lower-magnitude negative impact on sensitivity. This suggests that the integration of clinical expert-derived reasoning could improve the performance of LLM-based tools in the behavioral health setting.

Humans↗

Cancer-associated fusion transcripts: mechanisms, functional roles, and clinical implications.

Fusion transcripts are hybrid RNA molecules generated through genomic rearrangements or RNA-level fusion mechanisms. They represent important molecular features of many cancers and can function as oncogenic drivers, diagnostic biomarkers, prognostic indicators, and therapeutic targets. Since the discovery of the BCR::ABL1 fusion in chronic myeloid leukemia, numerous cancer-associated fusion transcripts have been identified across hematologic malignancies and solid tumors. These fusion events encompass diverse biological mechanisms, including constitutively active kinases, aberrant transcription factors, epigenetic regulators, and non-coding fusion RNAs. This review summarizes current knowledge of the mechanisms underlying fusion transcript formation, including genomic rearrangement-dependent and rearrangement-independent processes, as well as fusion circular RNAs. The functional roles of fusion transcripts in cancer biology and their clinical relevance as diagnostic, prognostic, and predictive biomarkers are discussed. In addition, recent advances in fusion transcript detection and characterization are reviewed, including next-generation sequencing, long-read sequencing, single-cell approaches, artificial intelligence-assisted computational methods, and CRISPR/Cas9-mediated strategies for functional modeling and functional validation of fusion transcripts. Despite the rapid expansion of fusion transcript catalogs, the biological and clinical significance of most identified fusion events remains incompletely understood. Future progress will depend on integrating advanced sequencing technologies, artificial intelligence-assisted computational prioritization, and systematic functional validation to distinguish clinically actionable fusion transcripts from biologically neutral events. Such multidisciplinary approaches will be essential for translating fusion transcript research into precision oncology and improving cancer diagnosis, patient stratification, and targeted therapy.

Humans↗