An AI-Based Clinical Decision Support System for Antibiotic Therapy in Sepsis (KINBIOTICS): Use Case Analysis
Bibliographic record
Abstract
Background: Antimicrobial resistances pose significant challenges in health care systems. Clinical decision support systems (CDSSs) represent a potential strategy for promoting a more targeted and guideline-based use of antibiotics. The integration of artificial intelligence (AI) into these systems has the potential to support physicians in selecting the most effective drug therapy for a given patient. Objective: This study aimed to analyze the feasibility of an AI-based CDSS pilot version for antibiotic therapy in sepsis patients and identify facilitating and inhibiting conditions for its implementation in intensive care medicine. Methods: The evaluation was conducted in 2 steps, using a qualitative methodology. Initially, expert interviews were conducted, in which intensive care physicians were asked to assess the AI-based recommendations for antibiotic therapy in terms of plausibility, layout, and design. Subsequently, focus group interviews were conducted to examine the technology acceptance of the AI-based CDSS. The interviews were anonymized and evaluated using content analysis. Results: In terms of the feasibility, barriers included variability in previous antibiotic administration practices, which affected the predictive ability of AI recommendations, and the increased effort required to justify deviations from these recommendations. Physicians' confidence in accepting or rejecting recommendations depended on their level of professional experience. The ability to re-evaluate CDSS recommendations and an intuitive, user-friendly system design were identified as factors that enhanced acceptance and usability. Overall, barriers included low levels of digitization in clinical practice, limited availability of cross-sectoral data, and negative previous experiences with CDSSs. Conversely, facilitators to CDSS implementation were potential time savings, physicians' openness to adopting new technologies, and positive previous experiences. Conclusions: Early integration of users is beneficial for both the identification of relevant context factors and the further development of an effective CDSS. Overall, the potential of AI-based CDSSs is offset by inhibiting contextual conditions that impede its acceptance and implementation. The advancement of AI-based CDSSs and the mitigation of these inhibiting conditions are crucial for the realization of its full potential.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".