Evaluating the efficacy of artificial intelligence tools for the automation of systematic reviews in cancer research: A systematic review.

To evaluate the performance accuracy and workload savings of artificial intelligence (AI)-based automation tools in comparison with human reviewers in medical literature screening for systematic reviews (SR) of primary studies in cancer research in order to gain insights on improving the efficiency of producing SRs. Medline, Embase, the Cochrane Library, and PROSPERO databases were searched from inception to November 30, 2022. Then, forward and backward literature searches were completed, and the experts in this field including the authors of the articles included were contacted for a thorough grey literature search. This SR was registered on PROSPERO (CRD 42023384772). Among the 3947 studies obtained from search, five studies met the preplanned study selection criteria. These five studies evaluated four AI tools: Abstrackr (four studies), RobotAnalyst (one), EPPI-Reviewer (one), and DistillerSR (one). Without missing final included citations, Abstrackr eliminated 20%-88% of titles and abstracts (time saving of 7-86 hours) and 59% of the full-texts (62 h) from human review across four different cancer-related SRs. In comparison, RobotAnalyst (1% of titles and abstracts, 1 h), EPPI Review (38% of titles and abstracts, 58 h; 59% of full-texts, 62 h), DistillerSR (42% of titles and abstracts, 22 h) also provided similar or lower work savings for single cancer-related SRs. AI-based automation tools exhibited promising but varying levels of accuracy and efficiency during the screening process of medical literature for conducting SRs in the cancer field. Until further progress is made and thorough evaluations are conducted, AI tools should be utilized as supplementary aids rather than complete substitutes for human reviewers.

Hip Arthroscopy Improves Outcomes With Moderate Conversion to Total Hip Arthroplasty Rates in Patients Aged 50 Years or Older: A Systematic Review.

PURPOSE: The purpose of this systematic review was to assess the indications, outcomes, and complications of hip arthroscopy in individuals 50 years of age or older over the past 5 years. METHODS: The electronic databases PUBMED, MEDLINE, and EMBASE were searched on March 3, 2022, for studies assessing the use of primary hip arthroscopy for patients aged 50 years or older from the past 5 years. The Methodological Index for Non-randomized Studies (MINORS) was used to assess study quality. Data are presented descriptively. RESULTS: Overall, 17 studies were included, consisting of 6,696 patients (37.5%) with a mean age of 61.4 ± 5.0 years and a median follow-up of 24 months (range: 1.4-70.1). Indications for hip arthroscopy in patients aged 50 years or older were unspecified/undefined (93.8%), mixed pathology (i.e., combined femoroacetabular impingement [FAI], labral tear, osteoarthritis, etc.) (2.7%), and FAI (2.6%). Eleven studies demonstrated significant improvement in functional outcome scores from baseline to final follow-up. Of the 6 studies that compared outcomes across multiple age groups, 3 demonstrated significantly worse functional outcomes, and 2 demonstrated significantly higher rates of conversion to THA for older patients compared to younger patients. Lastly, the overall complication rates ranged from 0 to 38.3%. The rate of conversion to THA ranged from 0 to 34.6%, occurring between 6 and 60 months postoperatively. CONCLUSIONS: Hip arthroscopy for patients aged 50 years or older yields significant improvements in patient-reported outcomes postoperatively compared to baseline, with a moderate rate of conversion to THA (range: 0 to 34.6%). Clinicians should consider patient history (e.g., imaging, comorbidities, etc.) and values when electing for hip arthroscopy in the older population. LEVEL OF EVIDENCE: IV, systematic review of Level III and IV studies.

Bilateral hip arthroscopy for treating femoroacetabular impingement: a systematic review.

PURPOSE: Femoroacetabular impingement (FAI) is a hip disorder which can often present bilaterally. The purpose of this systematic review was to explore the current practices for bilateral hip arthroscopy in treating FAI as they relate to outcomes and complications. METHODS: This review has been conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). The electronic databases PubMed, MEDLINE, EMBASE, and CENTRAL (Cochrane Central Register of Controlled Trials) were searched from data inception to October 18th, 2020. The Methodological Index for Non-randomized Studies (MINORS) was used to assess study quality. Data are presented descriptively. RESULTS: Overall, 19 studies were identified, comprising 957 patients (48.6% male) with a mean age of 27.9 ± 7.1 years and a mean follow-up of 31.7 ± 20.8 months. The majority of patients were treated with a staged bilateral hip arthroscopy (78.5%) with a mean duration between surgeries of 7.1 ± 4.0 months. Significant preoperative-to-postoperative improvements for clinical outcomes such as pain, hip function, and health-related daily living as well as radiographic outcomes were reported in six studies for staged procedures (p < 0.05) and three studies for simultaneous procedures (p < 0.02). Significant improvements in patient-reported outcomes (e.g., HOS-ADL, Pain, HOS-SS, mHHS, and NAHS) were found in favor of those undergoing a shorter delay between surgeries in three studies (i.e., < 3, 10 or 17 months) (p < 0.05) compared to those who had delayed surgeries (i.e., > 3, 10, or 17 months). The overall complication rate was 10.1% (97/957). CONCLUSIONS: Bilateral surgery for FAI yields improved outcomes postoperatively and complication rates similar to unilateral surgery. The overall complication rate was 10.1% with the most common complication being revision surgery. Staged bilateral surgery is more commonly performed than simultaneous surgery. Clinicians should consider preoperative imaging, clinical history, and patient values when deciding between staged and simultaneous procedures for bilateral FAI surgery. Future studies are required to determine the optimal indications for simultaneous versus staged procedures, as well as the ideal timing between surgeries for the latter. LEVEL OF EVIDENCE: Level IV.