Use of artificial intelligence to support prehospital traumatic injury care: A scoping review

Author:

Toy Jake123ORCID,Warren Jonathan123,Wilhelm Kelsey123,Putnam Brant4,Whitfield Denise123,Gausche‐Hill Marianne123,Bosson Nichole123,Donaldson Ross135,Schlesinger Shira123,Cheng Tabitha13,Goolsby Craig13

Affiliation:

1. The Lundquist Institute, Department of Emergency Medicine Harbor‐UCLA Medical Center Torrance California USA

2. Los Angeles Emergency Medical Services Agency Santa Fe Springs California USA

3. David Geffen School of Medicine at UCLA Los Angeles California USA

4. Department of Surgery Harbor‐UCLA Medical Center Torrance California USA

5. Critical Innovations LLC Los Angeles California USA

Abstract

AbstractBackgroundArtificial intelligence (AI) has transformative potential to support prehospital clinicians, emergency physicians, and trauma surgeons in acute traumatic injury care. This scoping review examines the literature evaluating AI models using prehospital features to support early traumatic injury care.MethodsWe conducted a systematic search in August 2023 of PubMed, Embase, and Web of Science. Two independent reviewers screened titles/abstracts, with a third reviewer for adjudication, followed by a full‐text analysis. We included original research and conference presentations evaluating AI models—machine learning (ML), deep learning (DL), and natural language processing (NLP)—that used prehospital features or features available immediately upon emergency department arrival. Review articles were excluded. The same investigators extracted data and systematically categorized outcomes to ensure consistency and transparency. We calculated kappa for interrater reliability and descriptive statistics.ResultsWe identified 1050 unique publications, with 49 meeting inclusion criteria after title and abstract review (kappa 0.58) and full‐text review. Publications increased annually from 2 in 2007 to 10 in 2022. Geographic analysis revealed a 61% focus on data from the United States. Studies were predominantly retrospective (88%), used local (45%) or national level (41%) data, focused on adults only (59%) or did not specify adults or pediatrics (27%), and 57% encompassed both blunt and penetrating injury mechanisms. The majority used machine learning (88%) alone or in conjunction with DL or NLP, and the top three algorithms used were support vector machine, logistic regression, and random forest. The most common study objectives were to predict the need for critical care and life‐saving interventions (29%), assist in triage (22%), and predict survival (20%).ConclusionsA small but growing body of literature described AI models based on prehospital features that may support decisions made by dispatchers, Emergency Medical Services clinicians, and trauma teams in early traumatic injury care.

Publisher

Wiley

Reference67 articles.

1. American College of Surgeons.National guidelines for the field triage of injured patients. Accessed December 26 2023.https://www.facs.org/quality‐programs/trauma/systems/field‐triage‐guidelines/

2. The National Highway Traffic Safety Administration Office of EMS.National EMS scope of practice model. Accessed December 26 2023.https://www.ems.gov/national‐ems‐scope‐of‐practice‐model

3. Centers for Disease Control and Prevention.FastStats—Leading causes of death. Published January 18 2023. Accessed December 26 2023.https://www.cdc.gov/nchs/fastats/leading‐causes‐of‐death.htm

4. World Health Organization.The top 10 causes of death. Published 2020. Accessed December 26 2023.https://www.who.int/news‐room/fact‐sheets/detail/the‐top‐10‐causes‐of‐death

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