Israel Medical Association Journal

In this special issue of Israel Medical Association Journal (IMAJ) we expose readers to the topic of artificial intelligence (AI) in medicine. AI has become a powerful tool, which enables healthcare professionals to personalize treatment based on many factors, including genetic analyses of tumors, and to consider other co-morbidities affecting a specific patient. AI gives physicians the ability to analyze huge amounts of data and to combine data from different sources. AI can be implemented make a diagnosis based on computed tomography (CT) scans and magnetic resonance imaging (MRI) scans using deep machine learning and data that are stored in the memory of mega computers. AI assists in tailoring more precise surgery to train surgeons before surgery and to support surgeons during procedures. This advancement may benefit surgical procedures by making them more accurate and faster without cutting unnecessary tissues (e.g., nerves and blood vessels); thus, patients face fewer complications, lower rates of infection, and more operation theater time. In this issue, we include three original studies that describe the use of AI in academia and eight review articles that discuss applications of AI in different specialties in medicine. One of the review articles addresses ethical issues and concerns that are raised due to the more advanced use of AI in medicine.

Artificial intelligence in ophthalmology is used for automatic diagnosis, data analysis, and predicting responses to possible treatments. The potential challenges in the application and assimilation of artificial intelligence include technical challenges of the algorithms, the ability to explain the algorithm, and the ability to diagnose and manage the medical course of patients. Despite these challenges, artificial intelligence is expected to revolutionize the way ophthalmology will be practiced. In this review, we compiled recent reports on the use and application of deep learning in various fields of ophthalmology, potential challenges in clinical deployment, and future directions.

Artificial intelligence (AI) has emerged as a powerful technology in medicine, with a potential to revolutionize various aspects of disease management. In recent years, substantial progress has been made in the development and implementation of AI algorithms and models for the diagnosis, screening, and monitoring of retinal diseases. We present a brief update on recent advancements in the implementation of AI in the field of retinal medicine, with a focus on age-related macular degeneration, diabetic retinopathy, and retinopathy of prematurity. AI algorithms have demonstrated remarkable capabilities in automating image analysis tasks, thus enabling accurate segmentation and classification of retinal pathologies. AI-based screening programs hold great promise in cost-effective identification of individuals at risk, thereby facilitating early intervention and prevention. Future integration of multimodal imaging data including optical coherence tomography with additional clinical parameters, will further enhance the diagnostic accuracy and support the development of personalized medicine, thus aiding in treatment selection and optimizing therapeutic outcomes. Further research and collaboration will drive the transformation of AI into an indispensable tool for improving patient outcomes and enhancing the field of retinal medicine.

Artificial intelligence (AI) has emerged as a transformative group of technologies in the field of medicine. Specifically in cardiology, numerous applications have materialized, and these are developing exponentially. AI-based risk prediction models leverage machine learning algorithms and large datasets to probe multiple variables, aid in the identification of individuals at high risk for adverse events, facilitate early interventions, and enable personalized risk assessments. Unique algorithms analyze medical images, such as electrocardiograms, echocardiograms, and cardiac computed tomography scans to enable rapid detection of abnormalities and aid in the accurate identification of cardiac pathologies. AI has also shown promise in guiding treatment decisions during coronary catheterization. In addition, AI has revolutionized remote patient monitoring and disease management by means of wearable and implantable sensing technologies. In this review, we discussed the field of cardiovascular genetics and personalized medicine, where AI holds great promise. While the applications of AI in cardiology are promising, challenges such as data privacy, interpretability of the findings, and multiple matters regarding ethics need to be addressed. We presented a succinct overview of the applications of AI in cardiology, highlighting its potential to revolutionize risk prediction, diagnosis, treatment, and personalized patient care.

A rise in the incidence of chronic health conditions, notably heart failure, is expected due to demographic shifts. Such an increase places an onerous burden on healthcare infrastructures, with recurring hospital admissions and heightened mortality rates being prominent factors. Efficient chronic disease management hinges on regular ambulatory care and preemptive action. The application of intelligent computational models is showing promise as a key resource in the ongoing management of chronic diseases, particularly in forecasting disease trajectory and informing timely interventions. In this review, we explored a pioneering intelligent computational model by Diagnostic Robotics, an Israeli start-up company. This model uses data sourced from insurance claims to forecast the progression of heart failure. The goal of the model is to identify individuals at increased risk for heart failure, thus enabling interventions to be initiated early, mitigating the risk of disease worsening, and relieving the pressure on healthcare facilities, which will result in economic efficiencies.

Over the last decade the use of artificial intelligence (AI) has reformed academic research. While clinical diagnosis of psoriasis and psoriatic arthritis is largely straightforward, the determining factors of a clinical response to therapy, and specifically to biologic agents, have not yet been found. AI may meaningfully impact attempts to unravel the prognostic factors that affect response to therapy, assist experimental techniques being used to investigate immune cell populations, examine whether these populations are associated with treatment responses, and incorporate immunophenotype data in prediction models. The aim of this mini review was to present the current state of the AI-mediated attempts in the field. We executed a Medline search in October 2023. Selection and presentation of studies were conducted following the principles of a narrative–review design. We present data regarding the impact AI can have on the management of psoriatic disease by predicting responses utilizing clinical or biological parameters. We also reviewed the ways AI has been implemented to assist development of models that revolutionize the investigation of peripheral immune cell subsets that can be used as biomarkers of response to biologic treatment. Last, we discussed future perspectives and ethical considerations regarding the use of machine learning models in the management of immune-mediated diseases.

Medical imaging data has been at the frontier of artificial intelligence innovation in medicine with many clinical applications. There have been many challenges, including patient data protection, algorithm performance, radiology workflow, user interface, and IT integration, which have been addressed and mitigated over the last decade. The AI products in imaging now fall into three main categories: triage artificial intelligence (AI), productivity AI, and augmented AI, each providing a different utility for radiologists, clinicians, and patients. Adoption of AI products into the healthcare system has been slow, but it is growing. It is typically dictated by return on investment, which can be demonstrated in each use case. It is expected to lead to wider adoption of AI products in imaging into the clinical workflow in the future.

In recent years, we have been experiencing a technological revolution, which signifies an ethical and societal transformation. Artificial intelligence (AI) based technologies have gradually permeated all aspects of life and solidified their position. Within this context, the emergence of these technologies offers new opportunities in the medical field, including palliative care, which is aimed at alleviating suffering and improving the quality of life for terminally ill patients and their families. In Israel, the Dying Patient Act of 2005 (the law), which promotes values such as the sanctity of life and individual autonomy, allows terminally ill patients to determine their preferred treatment, and withhold life-saving treatment under certain circumstances. The law represents a significant step toward improving care for terminally ill patients, reducing pain and suffering, and respecting the patient's wishes and worldviews in their final days. However, the practical implementation of the law has encountered numerous challenges, ranging from lack of familiarity among doctors and healthcare professionals and the requirement to determining life expectancy to fulfilling the law's purpose. These challenges are associated with ethical, cultural, and religious perspectives. In this article, we describe how AI-based technologies hold immense potential in applying the law and providing palliative care based on their predictive capabilities, prognostic accuracy, and optimization of treatment as well as communication between patients and healthcare providers. However, as an innovative, developing, and complex technology, it is crucial not to overlook the ethical, societal, and legal challenges inherent in implementing and using AI-based technologies in the context of palliative care.