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In the much-celebrated book Deep Medicine, Eric Topol argues that the development of artificial intelligence for health care will lead to a dramatic shift in the culture and practice of medicine. In the next several decades, he suggests, AI will become sophisticated enough that many of the everyday tasks of physicians could be delegated to it. Topol is perhaps the most articulate advocate of the benefits of AI in medicine, but he is hardly alone in spruiking its potential to allow physicians to dedicate more of their time and attention to providing empathetic care for their patients in the future. Unfortunately, several factors suggest a radically different picture for the future of health care. Far from facilitating a return to a time of closer doctor-patient relationships, the use of medical AI seems likely to further erode therapeutic relationships and threaten professional and patient satisfaction.
The medical ecosystem consists of the training of new clinicians and researchers, the practice of clinical medicine, and areas of adjacent research. There are many aspects of these domains that could benefit from the application of task automation and programmatic assistance. Machine learning and artificial intelligence techniques, including large language models (LLMs), have been promised to deliver on healthcare innovation, improving care speed and accuracy, and reducing the burden on staff for manual interventions. However, LLMs have no understanding of objective truth that is based in reality. They also represent real risks to the disclosure of protected information when used by clinicians and researchers. The use of AI in medicine in general, and the deployment of LLMs in particular, therefore requires careful consideration and thoughtful application to reap the benefits of these technologies while avoiding the dangers in each context.
What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It's also highly likely to impact on the organisational and business practices of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare ins
Demand for health care is constantly increasing due to the ongoing demographic change, while at the same time health service providers face difficulties in finding skilled personnel. This creates pressure on health care systems around the world, such that the efficient, nationwide provision of primary health care has become one of society's greatest challenges. Due to the complexity of health care systems, unforeseen future events, and a frequent lack of data, analyzing and optimizing the performance of health care systems means tackling a wicked problem. To support this task for primary care, this paper introduces the hybrid agent-based simulation model SiM-Care. SiM-Care models the interactions of patients and primary care physicians on an individual level. By tracking agent interactions, it enables modelers to assess multiple key indicators such as patient waiting times and physician utilization. Based on these indicators, primary care systems can be assessed and compared. Moreover, changes in the infrastructure, patient behavior, and service design can be directly evaluated. To showcase the opportunities offered by SiM-Care and aid model validation, we present a case study for
Medicine, including fields in healthcare and life sciences, has seen a flurry of quantum-related activities and experiments in the last few years (although biology and quantum theory have arguably been entangled ever since Schrödinger's cat). The initial focus was on biochemical and computational biology problems; recently, however, clinical and medical quantum solutions have drawn increasing interest. The rapid emergence of quantum computing in health and medicine necessitates a mapping of the landscape. In this review, clinical and medical proof-of-concept quantum computing applications are outlined and put into perspective. These consist of over 40 experimental and theoretical studies. The use case areas span genomics, clinical research and discovery, diagnostics, and treatments and interventions. Quantum machine learning (QML) in particular has rapidly evolved and shown to be competitive with classical benchmarks in recent medical research. Near-term QML algorithms have been trained with diverse clinical and real-world data sets. This includes studies in generating new molecular entities as drug candidates, diagnosing based on medical image classification, predicting patient pe
The academic journal zoning system is central to evaluating research talent, funding, and institutions. The CAS journal partition system, one of East Asia's most widely used tools, will cease operation in March 2026, creating a policy gap. Existing alternatives have major limitations: JCR depends on paid databases and excludes conferences; Scimago/CiteScore relies on Elsevier proprietary data; expert-based rankings such as CCF and CORE lack quantitative foundations and update slowly. This paper proposes the General Science Ranking (GSR), a multidimensional bibliometric framework built entirely on open-source data. GSR covers 500 computer science venues (397 journals and 103 conferences) and 500 medical journals using OpenAlex and Semantic Scholar. Scores combine four indicators: field-weighted citation impact (FWCI), two-year impact factor (IF2), five-year h-index (h5), and citation CAGR. For CS conferences lacking citation time-series data, IF2-approx was estimated from calibration on 1.41 million OpenAlex journal papers. Rankings adopt fixed quotas: Q1 (1-50), Q2 (51-100), Q3 (101-200), and Q4 (201+). All code and data are open source. In CS rankings, conferences and journals eac
This study examines the social media uptake of scientific journals on two different platforms - X and WeChat - by comparing the adoption of X among journals indexed in the Science Citation Index-Expanded (SCIE) with the adoption of WeChat among journals indexed in the Chinese Science Citation Database (CSCD). The findings reveal substantial differences in platform adoption and user engagement, shaped by local contexts. While only 22.7% of SCIE journals maintain an X account, 84.4% of CSCD journals have a WeChat official account. Journals in Life Sciences & Biomedicine lead in uptake on both platforms, whereas those in Technology and Physical Sciences show high WeChat uptake but comparatively lower presence on X. User engagement on both platforms is dominated by low-effort interactions rather than more conversational behaviors. Correlation analyses indicate weak-to-moderate relationships between bibliometric indicators and social media metrics, confirming that online engagement reflects a distinct dimension of journal impact, whether on an international or a local platform. These findings underscore the need for broader social media metric frameworks that incorporate locally dom
We compare the network of aggregated journal-journal citation relations provided by the Journal Citation Reports (JCR) 2012 of the Science and Social Science Citation Indexes (SCI and SSCI) with similar data based on Scopus 2012. First, global maps were developed for the two sets separately; sets of documents can then be compared using overlays to both maps. Using fuzzy-string matching and ISSN numbers, we were able to match 10,524 journal names between the two sets; that is, 96.4% of the 10,936 journals contained in JCR or 51.2% of the 20,554 journals covered by Scopus. Network analysis was then pursued on the set of journals shared between the two databases and the two sets of unique journals. Citations among the shared journals are more comprehensively covered in JCR than Scopus, so the network in JCR is denser and more connected than in Scopus. The ranking of shared journals in terms of indegree (that is, numbers of citing journals) or total citations is similar in both databases overall (Spearman's \r{ho} > 0.97), but some individual journals rank very differently. Journals that are unique to Scopus seem to be less important--they are citing shared journals rather than bein
An exploratory, descriptive analysis is presented of the national orientation of scientific, scholarly journals as reflected in the affiliations of publishing or citing authors. It calculates for journals covered in Scopus an Index of National Orientation (INO), and analyses the distribution of INO values across disciplines and countries, and the correlation between INO values and journal impact factors. The study did not find solid evidence that journal impact factors are good measures of journal internationality in terms of the geographical distribution of publishing or citing authors, as the relationship between a journal's national orientation and its citation impact is found to be inverse U-shaped. In addition, journals publishing in English are not necessarily internationally oriented in terms of the affiliations of publishing or citing authors; in social sciences and humanities also USA has their nationally oriented literatures. The paper examines the extent to which nationally oriented journals entering Scopus in earlier years, have become in recent years more international. It is found that in the study set about 40 per cent of such journals does reveal traces of internati
Overlay journals are characterised by their articles being published on open access repositories, often already starting in their initial preprint form as a prerequisite for submission to the journal prior to initiating the peer-review process. In this study we aimed to identify currently active overlay journals and examine their characteristics. We utilised an explorative web search and contacted key service providers for additional information. The final sample consisted of 34 overlay journals. While the results show that new overlay journals have been actively established within recent years, the current presence of overlay journals remains diminutive compared to the overall number of open access journals. Most overlay journals publish articles in natural sciences, mathematics or computer sciences, and are commonly published by groups of academics rather than formal organisations. They may also rank highly within the traditional journal citation metrics. None of the investigated journals required fees from authors, which is likely related to the cost-effective aspects of the overlay publishing model. Both the growth in adoption of open access preprint repositories and researcher
With the rapid development of artificial intelligence (AI), large language models (LLMs) have shown strong capabilities in natural language understanding, reasoning, and generation, attracting amounts of research interest in applying LLMs to health and medicine. Critical care medicine (CCM) provides diagnosis and treatment for critically ill patients who often require intensive monitoring and interventions in intensive care units (ICUs). Can LLMs be applied to CCM? Are LLMs just like stochastic parrots or ICU experts in assisting clinical decision-making? This scoping review aims to provide a panoramic portrait of the application of LLMs in CCM. Literature in seven databases, including PubMed, Embase, Scopus, Web of Science, CINAHL, IEEE Xplore, and ACM Digital Library, were searched from January 1, 2019, to June 10, 2024. Peer-reviewed journal and conference articles that discussed the application of LLMs in critical care settings were included. From an initial 619 articles, 24 were selected for final review. This review grouped applications of LLMs in CCM into three categories: clinical decision support, medical documentation and reporting, and medical education and doctor-patien
We find ourselves on the ever-shifting cusp of an AI revolution -- with potentially metamorphic implications for the future practice of healthcare. For many, such innovations cannot come quickly enough; as healthcare systems worldwide struggle to keep up with the ever-changing needs of our populations. And yet, the potential of AI tools and systems to shape healthcare is as often approached with great trepidation as celebrated by health professionals and patients alike. These fears alight not only in the form of privacy and security concerns but for the potential of AI tools to reduce patients to datapoints and professionals to aggregators -- to make healthcare, in short, less caring. This infixated concern, we - as designers, developers and researchers of AI systems - believe it essential we tackle head on; if we are not only to overcome the AI implementation gap, but realise the potential of AI systems to truly augment human-centred practices of care. This, we argue we might yet achieve by realising newly-accessible practices of AI healthcare innovation, engaging providers, recipients and affected communities of care in the inclusive design of AI tools we may yet enthusiastically
This review underscores the vital role of interoperability in digital health, advocating for a standardized framework. It focuses on implementing a Fast Healthcare Interoperability Resources (FHIR) server, addressing technical, semantic, and process challenges. FHIR's adaptability ensures uniformity within Primary Care Health Information Systems, fostering interoperability. Patient data management complexities highlight the pivotal role of semantic interoperability in seamless patient care. FHIR standards enhance these efforts, offering multiple pathways for data search. The ADR-guided FHIR server implementation systematically addresses challenges related to patient identity, biometrics, and data security. The detailed development phases emphasize architecture, API integration, and security. The concluding stages incorporate forward-looking approaches, including HHIMS Synthetic Dataset testing. Envisioning FHIR integration as transformative, it anticipates a responsive healthcare environment aligned with the evolving digital health landscape, ensuring comprehensive, dynamic, and interconnected systems for efficient data exchange and access.
Interdisciplinary research is critical for innovation and addressing complex societal issues. We characterise the interdisciplinary knowledge structure of PubMed research articles in medicine as correlation networks of medical concepts and compare the interdisciplinarity of articles between high-ranking (impactful) and less high-ranking (less impactful) medical journals. We found that impactful medical journals tend to publish research that are less interdisciplinary than less impactful journals. Observing that they bridge distant knowledge clusters in the networks, we find that cancer-related research can be seen as one of the main drivers of interdisciplinarity in medical science. Using signed difference networks, we also investigate the clustering of deviations between high and low impact journal correlation networks. We generally find a mild tendency for strong link differences to be adjacent. Furthermore, we find topic clusters of deviations that shift over time. In contrast, topic clusters in the original networks are static over time and can be seen as the core knowledge structure in medicine. Overall, journals and policymakers should encourage initiatives to accommodate int
Using "Analyze Results" at the Web of Science, one can directly generate overlays onto global journal maps of science. The maps are based on the 10,000+ journals contained in the Journal Citation Reports (JCR) of the Science and Social Science Citation Indices (2011). The disciplinary diversity of the retrieval is measured in terms of Rao-Stirling's "quadratic entropy." Since this indicator of interdisciplinarity is normalized between zero and one, the interdisciplinarity can be compared among document sets and across years, cited or citing. The colors used for the overlays are based on Blondel et al.'s (2008) community-finding algorithms operating on the relations journals included in JCRs. The results can be exported from VOSViewer with different options such as proportional labels, heat maps, or cluster density maps. The maps can also be web-started and/or animated (e.g., using PowerPoint). The "citing" dimension of the aggregated journal-journal citation matrix was found to provide a more comprehensive description than the matrix based on the cited archive. The relations between local and global maps and their different functions in studying the sciences in terms of journal lit
Rankings of scholarly journals based on citation data are often met with skepticism by the scientific community. Part of the skepticism is due to disparity between the common perception of journals' prestige and their ranking based on citation counts. A more serious concern is the inappropriate use of journal rankings to evaluate the scientific influence of authors. This paper focuses on analysis of the table of cross-citations among a selection of Statistics journals. Data are collected from the Web of Science database published by Thomson Reuters. Our results suggest that modelling the exchange of citations between journals is useful to highlight the most prestigious journals, but also that journal citation data are characterized by considerable heterogeneity, which needs to be properly summarized. Inferential conclusions require care in order to avoid potential over-interpretation of insignificant differences between journal ratings. Comparison with published ratings of institutions from the UK's Research Assessment Exercise shows strong correlation at aggregate level between assessed research quality and journal citation `export scores' within the discipline of Statistics.
A number of journal classification systems have been developed in bibliometrics since the launch of the Citation Indices by the Institute of Scientific Information (ISI) in the 1960s. These systems are used to normalize citation counts with respect to field-specific citation patterns. The best known system is the so-called "Web-of-Science Subject Categories" (WCs). In other systems papers are classified by algorithmic solutions. Using the Journal Citation Reports 2014 of the Science Citation Index and the Social Science Citation Index (n of journals = 11,149), we examine options for developing a new system based on journal classifications into subject categories using aggregated journal-journal citation data. Combining routines in VOSviewer and Pajek, a tree-like classification is developed. At each level one can generate a map of science for all the journals subsumed under a category. Nine major fields are distinguished at the top level. Further decomposition of the social sciences is pursued for the sake of example with a focus on journals in information science (LIS) and science studies (STS). The new classification system improves on alternative options by avoiding the problem
Using Scopus data, we construct a global map of science based on aggregated journal-journal citations from 1996-2012 (N of journals = 20,554). This base map enables users to overlay downloads from Scopus interactively. Using a single year (e.g., 2012), results can be compared with mappings based on the Journal Citation Reports at the Web-of-Science (N = 10,936). The Scopus maps are more detailed at both the local and global levels because of their greater coverage, including, for example, the arts and humanities. The base maps can be interactively overlaid with journal distributions in sets downloaded from Scopus, for example, for the purpose of portfolio analysis. Rao-Stirling diversity can be used as a measure of interdisciplinarity in the sets under study. Maps at the global and the local level, however, can be very different because of the different levels of aggregation involved. Two journals, for example, can both belong to the humanities in the global map, but participate in different specialty structures locally. The base map and interactive tools are available online (with instructions) at http://www.leydesdorff.net/scopus_ovl.
Relationship-centred care (RCC) recognises that healthcare quality depends not only on outcomes, but on how voice, responsibility, and emotional labour are negotiated among patients, caregivers, and providers. As AI systems enter sensitive care contexts, they introduce a new participant into these negotiations. Drawing on empirical work in Advance Care Planning (ACP) and peer support, we argue that AI's primary impact in high-subjectivity domains is not optimisation but redistribution: it reorganises who speaks, who decides, and who bears moral responsibility. Across both settings, participants were less concerned with technical accuracy than with relational consequences: whether AI would appropriately represent their decision, reduce burden, or blur accountability, scaffold connection, or subtly displace it. We identify three relational dimensions: authority, temporality, and visibility, through which AI reshapes care relationships, and propose design provocations centred on relational legibility, bounded agency, responsibility traceability, and non-substitutive scaffolding.
Publication patterns of 79 forest scientists awarded major international forestry prizes during 1990-2010 were compared with the journal classification and ranking promoted as part of the 'Excellence in Research for Australia' (ERA) by the Australian Research Council. The data revealed that these scientists exhibited an elite publication performance during the decade before and two decades following their first major award. An analysis of their 1703 articles in 431 journals revealed substantial differences between the journal choices of these elite scientists and the ERA classification and ranking of journals. Implications from these findings are that additional cross-classifications should be added for many journals, and there should be an adjustment to the ranking of several journals relevant to the ERA Field of Research classified as 0705 Forestry Sciences.