Randomized Clinical Trials of Artificial Intelligence

March 17, 2020, Vol 323, No. 11, Pages 1021-1104


Randomized Clinical Trials of Artificial Intelligence
Derek C. Angus, MD, MPH
JAMA. 2020;323(11):1043-1045. doi:10.1001/jama.2020.1039
As patient data are increasingly captured digitally, the opportunities to deploy artificial intelligence (AI), especially machine learning, are increasing rapidly. Machine learning is automated learning by computers using tools such as artificial neural networks to search data iteratively for optimal solutions.1 Typical applications include searching for novel patterns (eg, latent cancer subtypes2), making a diagnosis or outcome prediction (eg, diabetic retinopathy3), and optimizing treatment decisions (eg, fluid and vasopressor titration for septic shock4). Although many express excitement regarding the promise of AI, others express concern about adverse consequences, such as loss of physician and patient autonomy or unintended bias, and still others claim that the entire endeavor is largely hype, with virtually no data that actual patient outcomes have improved.5,6