Abstract
There exists great hope and hype in the literature surrounding applications of artificial
intelligence (AI) to orthopaedic surgery. Between 2018 and 2021, a total of 178 AI-related
articles were published in orthopaedics. However, for every 2 original research papers
that apply AI to orthopaedics, a commentary or review is published (30.3%). AI-related
research in orthopaedics frequently fails to provide use cases that offer the uninitiated
an opportunity to appraise the importance of AI by studying meaningful questions,
evaluating unknown hypotheses, or analyzing quality data. The hype perpetuates a feed-forward
cycle that relegates AI to a meaningless buzzword by rewarding those with nascent
understanding and rudimentary technical knowhow into committing several basic errors:
(1) inappropriately conflating vernacular (“AI/machine learning”), (2) repackaging
registry data, (3) prematurely releasing internally validated algorithms, (4) overstating
the “black box phenomenon” by failing to provide weighted analysis, (5) claiming to
evaluate AI rather than the data itself, and (6) withholding full model architecture
code. Relevant AI-specific guidelines are forthcoming, but forced application of the
original Transparent Reporting of a multivariable prediction model for Individual
Prognosis Or Diagnosis guidelines designed for regression analyses is irrelevant and
misleading. To safeguard meaningful use, AI-related research efforts in orthopaedics
should be (1) directed toward administrative support over clinical evaluation and
management, (2) require the use of the advanced model, and (3) answer a question that
was previously unknown, unanswered, or unquantifiable.
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Article info
Publication history
Published online: May 09, 2022
Accepted:
April 12,
2022
Received:
March 11,
2022
Footnotes
See commentary on page 2767
The authors report the following potential conflicts of interest or sources of funding: P.N.R. reports other from Conformis, Globus Medical, Johnson & Johnson, and Stryker, outside the submitted work; research support from FocusMotion; and is an editorial/governing board member of Arthroplasty. ICMJE author disclosure forms are available for this article online, as supplementary material.
Investigation performed at the Brigham & Women’s Hospital, Boston, Massachusetts, U.S.A.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
