Editorial  |   October 2018
Is This the Real Future of Anesthesiology?
Author Affiliations
  • N. Martin Giesecke, M.D.
    Editor, ASA MONITOR
Article Information
Cardiovascular Anesthesia / Neurosurgical Anesthesia / Technology / Equipment / Monitoring / Editorial
Editorial   |   October 2018
Is This the Real Future of Anesthesiology?
ASA Monitor 10 2018, Vol.82, 4-5.
ASA Monitor 10 2018, Vol.82, 4-5.
In their article “The Future of Anesthesiology: Artificial Intelligence Is Just Another ‘What’ That Will Serve Our ‘Why’,” John C. Alexander, M.D., M.B.A., and Girish P. Joshi, M.B.B.S., M.D., FFARCSI, report on a study that showed “a machine-learning algorithm was able to predict hypotension 15 minutes prior to clinical presentation.”1  Not surprisingly to those of us with critical care experience, the algorithm looked at arterial pressure waveforms to make its determination. One might dare say that it would be possible for me to make the same prediction, but in my case the patient would be treated to prevent the occurrence of hypotension. This would happen in a one-on-one situation, where I had the opportunity to care for the patient over a course of time, while staying vigilant about what was also taking place in the surgical field. Still, one would be naive to assume that such artificial intelligence (AI) will not eventually help a physician anesthesiologist extend care to multiple patients. In this iteration, AI would be in use in an O.R. with mid-level care providers (e.g., anesthesiologist assistants, nurse anesthetists) providing anesthesia care under the medical direction of a physician anesthesiologist. These same two authors also comment on “Narrow AI-Clinical Decision Tools” such as those used in certain automobile auto-pilot systems. They discuss how, with the autopilot systems, the Society of Automotive Engineers developed a classification system providing a standard language to create the hierarchy of the system. This multi-level architecture is designed around when a human driver must intervene. Their comment that ASA would be wise to consider a similar approach in laying the groundwork for future automation efforts in anesthesia is appropriate. ASA should be in control of this aspect of where our practice is likely to go in the not too distant years to come.
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