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Enterprise AI Analysis: Scoping review of deep learning research illuminates artificial intelligence chasm in otolaryngology-head and neck surgery

Enterprise AI Analysis Report

Scoping review of deep learning research illuminates artificial intelligence chasm in otolaryngology-head and neck surgery

A scoping review revealed an "AI chasm" in Otolaryngology - Head & Neck Surgery (OHNS), with nearly all deep learning studies (99.3%) being early-stage in silico proofs of concept. Only 0.7% conducted offline validation and zero (0%) clinical validation, despite an exponential increase in publications from 2012-2022. The research, spanning 48 countries and all OHNS subspecialties, primarily aimed to extend healthcare provider capabilities (56%) using image data (55%) and CNN models (63%). Recommendations include focusing on low-complexity tasks, adhering to reporting guidelines, and prioritizing clinical translation studies to bridge this gap.

Executive Impact Snapshot

Understand the critical AI opportunity and the current state of deep learning research in OHNS.

8.2 AI Opportunity Score
0 Publications in 2012
105 Publications in 2022
99.3% In Silico Proof-of-Concept Studies

Deep Analysis & Enterprise Applications

Select a topic to dive deeper, then explore the specific findings from the research, rebuilt as interactive, enterprise-focused modules.

Deep learning publications in OHNS have surged exponentially from 2012-2022, spanning 48 countries. This growth highlights a global interest in applying AI to the field.

AI research in OHNS covers all subspecialties, with a concentration in otology and neurotology (28%). The primary goals are extending healthcare provider capabilities (56%) and screening for medical conditions (30%).

Most studies rely on image input data (55%), particularly non-radiology images like otoscopy and laryngoscopy. Convolutional Neural Networks (CNNs) are the most used models (63%) for analyzing visual, audio, and electrophysiology data.

A critical finding is the 'AI chasm': 99.3% of studies are in silico proof-of-concept. Only 0.7% (3 studies) moved to offline validation, and zero (0%) achieved clinical validation. Adherence to reporting guidelines is also low (5.4%).

To bridge the chasm, the authors suggest focusing on low-complexity/low-risk tasks, strict adherence to reporting guidelines (e.g., STARD, TRIPOD), and prioritizing clinical translation studies with prospective and diverse datasets.

99.3% Deep learning studies in silico proof-of-concept stage
0 Publications in 2012
105 Publications in 2022

Enterprise Process Flow

In Silico Evaluation (Proof of Concept)
Offline Validation
Small-scale Clinical Validation
Large-scale Clinical Validation
Post-market Surveillance
Aspect OHNS AI Research State Recommended Best Practice
Clinical Validation
  • 0% of studies found
  • Significant 'AI Chasm'
  • Essential for real-world deployment
  • Prioritize low-risk, low-complexity tasks
Reporting Guidelines
  • Only 5.4% adherence
  • Limits reproducibility & transparency
  • Adhere to STARD, TRIPOD, CONSORT-AI
  • Standardize reporting for clarity
Prospective Evaluation
  • Only 2.3% of studies
  • Impacts generalizability
  • Multi-institutional prospective data preferred
  • Iterative local validation also valuable

Strategic Imperatives for OHNS AI

The review reveals a critical need for clinical validation in OHNS AI research. The current focus on early-stage, in silico studies means a significant gap exists before real-world utility can be achieved. To bridge this 'AI chasm', the paper recommends prioritizing AI applications for low-complexity, low-risk tasks, rigorous adherence to reporting guidelines for transparency, and a dedicated focus on clinical translation studies, including both multi-institutional prospective validation and iterative local validation. This strategic shift is vital for moving AI from proof-of-concept to impactful clinical deployment, ensuring safety, utility, and actionability.

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Your AI Implementation Roadmap

A phased approach to integrate AI strategically and effectively into your enterprise, addressing the specific challenges highlighted by this research.

Phase 1: Needs Assessment & Data Strategy

Identify specific low-complexity, high-impact tasks within OHNS for AI application. Develop a robust data acquisition and annotation strategy, focusing on diverse and high-quality datasets to ensure generalizability and fairness.

Phase 2: Model Development & In Silico Validation

Develop and refine deep learning models for identified tasks. Conduct rigorous in silico validation with independent test sets and cross-validation, adhering to reporting guidelines like STARD and TRIPOD. Emphasize model interpretability for trust.

Phase 3: Offline & Small-Scale Clinical Validation

Transition promising models to offline validation with prospective, real-world data in a 'silent' or 'shadow' mode. Initiate small-scale clinical validation studies at institutional level, focusing on safety, utility, and actionability in the intended clinical context.

Phase 4: Large-Scale Clinical Trials & Regulatory Review

Expand successful small-scale validations to large-scale, multi-institutional clinical trials, adhering to CONSORT-AI. Prepare for regulatory submissions (e.g., FDA) by demonstrating robust performance, safety, and clinical benefit. Address liability and monitoring plans.

Phase 5: Post-Market Surveillance & Continuous Improvement

Implement continuous post-market surveillance to monitor model performance, detect drift, and ensure ongoing safety and efficacy. Establish a feedback loop for continuous model improvement and adaptation, incorporating federated learning for data privacy and scale.

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