TY  - JOUR
AU  - Alexander, Natasha
AU  - Aftandilian, Catherine
AU  - Guo, Lin Lawrence
AU  - Plenert, Erin
AU  - Posada, Jose
AU  - Fries, Jason
AU  - Fleming, Scott
AU  - Johnson, Alistair
AU  - Shah, Nigam
AU  - Sung, Lillian
PY  - 2022
DA  - 2022/11/17
TI  - Perspective Toward Machine Learning Implementation in Pediatric Medicine: Mixed Methods Study
JO  - JMIR Med Inform
SP  - e40039
VL  - 10
IS  - 11
KW  - machine learning
KW  - clinical utilization
KW  - preferences
KW  - qualitative interviews
AB  - Background: Given the costs of machine learning implementation, a systematic approach to prioritizing which models to implement into clinical practice may be valuable. Objective: The primary objective was to determine the health care attributes respondents at 2 pediatric institutions rate as important when prioritizing machine learning model implementation. The secondary objective was to describe their perspectives on implementation using a qualitative approach. Methods: In this mixed methods study, we distributed a survey to health system leaders, physicians, and data scientists at 2 pediatric institutions. We asked respondents to rank the following 5 attributes in terms of implementation usefulness: the clinical problem was common, the clinical problem caused substantial morbidity and mortality, risk stratification led to different actions that could reasonably improve patient outcomes, reducing physician workload, and saving money. Important attributes were those ranked as first or second most important. Individual qualitative interviews were conducted with a subsample of respondents. Results: Among 613 eligible respondents, 275 (44.9%) responded. Qualitative interviews were conducted with 17 respondents. The most common important attributes were risk stratification leading to different actions (205/275, 74.5%) and clinical problem causing substantial morbidity or mortality (177/275, 64.4%). The attributes considered least important were reducing physician workload and saving money. Qualitative interviews consistently prioritized implementations that improved patient outcomes. Conclusions: Respondents prioritized machine learning model implementation where risk stratification would lead to different actions and clinical problems that caused substantial morbidity and mortality. Implementations that improved patient outcomes were prioritized. These results can help provide a framework for machine learning model implementation. 
SN  - 2291-9694
UR  - https://medinform.jmir.org/2022/11/e40039
UR  - https://doi.org/10.2196/40039
UR  - http://www.ncbi.nlm.nih.gov/pubmed/36394938
DO  - 10.2196/40039
ID  - info:doi/10.2196/40039
ER  -