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Canadian Journal of Cardiology
Editorial| Volume 37, ISSUE 8, P1156-1158, August 2021

Machine Learning, Predictive Analytics, and the Emperor's New Clothes: Why Artificial Intelligence Has Not Yet Replaced Conventional Approaches

Published:March 09, 2021DOI:https://doi.org/10.1016/j.cjca.2021.03.003
      The era of big data in medicine
      • Shah ND
      • Steyerberg EW
      • Kent DM
      Big data and predictive analytics: recalibrating expectations.
      is undoubtedly upon us, and the volume of data available to clinicians and researchers for predictive analytics will continue to expand as we increasingly incorporate information from electronic health records, wearable biosensors, genomics, proteomics, and other metabolomics data in the future.
      • McAlister FA
      • Laupacis A
      • Armstrong PW
      Finding the right balance between precision medicine and personalized care.
      With this explosion in data, there is increasing interest in—and enthusiasm for—the potential of artificial intelligence (particularly predictive analytics based on machine learning [ML] approaches) to usher in an era of data-driven precision medicine. In fact, the Food and Drug Administration has already approved a number of ML products for use in cardiology (such as the AliveCor Heart Monitor [AliveCor Inc, Mountain View, California] for detecting atrial fibrillation) and ML-derived polygenic risk scores have been reported for several cardiac conditions.
      • Quer G
      • Arnaout R
      • Henne M
      • Arnaout R
      Machine learning and the future of cardiovascular care.
      However, the systematic review by Cho et al.,
      • Cho SM
      • Austin PC
      • Ross HJ
      • et al.
      Machine learning compared with conventional statistical models for predicting myocardial infarction readmission and mortality: a systematic review.
      comparing the performance of predictive models generated by ML methods with those arising from conventional statistical methods in this issue of the Canadian Journal of Cardiology is a sobering reminder that, as Chen and Asch warned, “machine learning now rides atop the peak of inflated expectations.”
      • Chen JH
      • Asch SM
      Machine learning and prediction in medicine: beyond the peak of inflated expectations.
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      References

        • Shah ND
        • Steyerberg EW
        • Kent DM
        Big data and predictive analytics: recalibrating expectations.
        JAMA. 2018; 320: 27-28
        • McAlister FA
        • Laupacis A
        • Armstrong PW
        Finding the right balance between precision medicine and personalized care.
        CMAJ. 2017; 189: E1065-E1068
        • Quer G
        • Arnaout R
        • Henne M
        • Arnaout R
        Machine learning and the future of cardiovascular care.
        J Am Coll Cardiol. 2021; 77: 300-313
        • Cho SM
        • Austin PC
        • Ross HJ
        • et al.
        Machine learning compared with conventional statistical models for predicting myocardial infarction readmission and mortality: a systematic review.
        Can J Cardiol. 2021; 37: 1207-1214
        • Chen JH
        • Asch SM
        Machine learning and prediction in medicine: beyond the peak of inflated expectations.
        N Engl J Med. 2017; 376: 2507-2509
        • Christodoulou E
        • Ma J
        • Collins GS
        • Steyerberg EW
        • Verbakel JY
        • Van Calster B
        A systematic review shows no performance benefit of machine learning over logistic regression for clinical prediction models.
        J Clin Epidemiol. 2019; 110: 12-22
        • Van Calster B
        • McLernon DJ
        • van Smeden M
        • Wynants L
        • Steyerberg EW
        for the Evaluating diagnostic tests and prediction models Topic Group of the STRATOS initiative. Calibration: the Achilles heel of predictive analytics.
        BMC Med. 2019; 17: 230
        • Collins GS
        • Reitsma JB
        • Altman DG
        • Moons KGM
        Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement.
        BMJ. 2015; 350: g7594
        • Wolff RF
        • Moons KGM
        • Riley RD
        • et al.
        PROBAST: a tool to assess the risk of bias and applicability of prediction model studies.
        Ann Intern Med. 2019; 170: 51-58
        • Gulshan V
        • Peng L
        • Coram M
        • et al.
        Development and validation of a deep learning algorithm for detection of diabetic retinopathy in retinal fundus photographs.
        JAMA. 2016; 316: 2402-2410
        • Ehteshami Bejnordi B
        • Veta M
        • Johannes van Diest P
        • et al.
        for the CAMELYON16 Consortium. Diagnostic assessment of deep learning algorithms for detection of lymph node metastases in women with breast cancer.
        JAMA. 2017; 318: 2199-2210
        • Chang KC
        • Hsieh PH
        • Wu MY
        • et al.
        Usefulness of machine learning-based detection and classification of cardiac arrhythmias with 12-lead electrocardiograms.
        Can J Cardiol. 2021; 37: 94-104
        • Zou J
        • Schiebinger L
        AI can be sexist and racist: it's time to make it fair.
        Nature. 2018; 559: 324-326
        • Shameer K
        • Johnson KW
        • Glicksberg BS
        • Dudley JT
        • Sengupta PP
        Machine learning in cardiovascular medicine: are we there yet?.
        Heart. 2018; 104: 1156-1164
        • Malin BA
        • Emam KE
        • O'Keefe CM
        Biomedical data privacy: problems, perspectives, and recent advances.
        J Am Med Inform Assoc. 2013; 20: 2-6
        • Emanuel EJ
        • Wachter RM
        Artificial intelligence in health care: will the value match the hype?.
        JAMA. 2019; 321: 2281-2282
        • Steyerberg EW
        • Moons KGM
        • van der Windt DA
        • et al.
        Prognosis Research Strategy (PROGRESS) 3: prognostic model research.
        PLoS Med. 2013; 10e1001381
        • Majumdar SR
        • McAlister FA
        • Furberg CD
        From knowledge to practice in chronic cardiovascular disease: a long and winding road.
        J Am Coll Cardiol. 2004; 43: 1738-1742
        • Heckman GA
        • Hirdes JP
        • McKelvie RS
        The role of physicians in the era of big data.
        Can J Cardiol. 2020; 36: 19-21

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