Navigating uncertainty is fundamental to sound clinical decision-making. With the advent of artificial intelligence, mathematical approximations of disease states-expressed as entropy-offer a novel approach to quantify and communicate uncertainty. Although entropy is well established in fields like physics and computer science, its technical complexity has delayed its routine adoption in clinical reasoning. In this narrative review, we adhere to Shannon's definition of entropy from information processing theory and examine how it has been used in clinical decision-making over the last 15 years. Grounding our analysis in decision theory-which frames decisions in terms of states, acts, consequences, and preferences-we evaluated 20 studies that employed entropy. Our findings reveal that entropy is predominantly used to quantify uncertainty rather than directly guiding clinical actions. High-stakes fields such as oncology and radiology have led the way, using entropy to improve diagnostic accuracy and support risk assessment, while applications in neurology and hematology remain largely exploratory. Notably, no study has yet translated entropy into an operational, evidence-based decision-support framework. These results point to entropy's value as a quantitative tool in clinical reasoning, while also highlighting the need for prospective validation and the development of integrated clinical tools.

Artificial intelligence (AI) is rapidly emerging as a transformative force in pediatric nephrology, enabling improvements in diagnostic accuracy, therapeutic precision, and operational workflows. By integrating diverse datasets-including patient histories, genomics, imaging, and longitudinal clinical records-AI-driven tools can detect subtle kidney anomalies, predict acute kidney injury, and forecast disease progression. Deep learning models, for instance, have demonstrated the potential to enhance ultrasound interpretations, refine kidney biopsy assessments, and streamline pathology evaluations. Coupled with robust decision support systems, these innovations also optimize medication dosing and dialysis regimens, ultimately improving patient outcomes. AI-powered chatbots hold promise for improving patient engagement and adherence, while AI-assisted documentation solutions offer relief from administrative burdens, mitigating physician burnout. However, ethical and practical challenges remain. Healthcare professionals must receive adequate training to harness AI's capabilities, ensuring that such technologies bolster rather than erode the vital doctor-patient relationship. Safeguarding data privacy, minimizing algorithmic bias, and establishing standardized regulatory frameworks are critical for safe deployment. Beyond clinical care, AI can accelerate pediatric nephrology research by identifying biomarkers, enabling more precise patient recruitment, and uncovering novel therapeutic targets. As these tools evolve, interdisciplinary collaborations and ongoing oversight will be key to integrating AI responsibly. Harnessing AI's vast potential could revolutionize pediatric nephrology, championing a future of individualized, proactive, and empathetic care for children with kidney diseases. Through strategic collaboration and transparent development, these advanced technologies promise to minimize disparities, foster innovation, and sustain compassionate patient-centered care, shaping a new horizon in pediatric nephrology research and practice.

Lung transplantation remains a critical treatment for end-stage lung diseases, yet it continues to have 1 of the lowest survival rates among solid organ transplants. Despite its life-saving potential, the field faces several challenges, including organ shortages, suboptimal donor matching, and post-transplant complications. The rapidly advancing field of artificial intelligence (AI) offers significant promise in addressing these challenges. Traditional statistical models, such as linear and logistic regression, have been used to predict post-transplant outcomes but struggle to adapt to new trends and evolving data. In contrast, machine learning algorithms can evolve with new data, offering dynamic and updated predictions. AI holds the potential to enhance lung transplantation at multiple stages. In the pre-transplant phase, AI can optimize waitlist management, refine donor selection, and improve donor-recipient matching, and enhance diagnostic imaging by harnessing vast datasets. Post-transplant, AI can help predict allograft rejection, improve immunosuppressive management, and better forecast long-term patient outcomes, including quality of life. However, the integration of AI in lung transplantation also presents challenges, including data privacy concerns, algorithmic bias, and the need for external clinical validation. This review explores the current state of AI in lung transplantation, summarizes key findings from recent studies, and discusses the potential benefits, challenges, and ethical considerations in this rapidly evolving field, highlighting future research directions.

Congenital heart diseases (CHD) are a significant cause of neonatal mortality and morbidity. Detecting these abnormalities during pregnancy increases survival rates, enhances prognosis, and improves pregnancy management and quality of life for the affected families. Foetal echocardiography can be considered an accurate method for detecting CHDs. However, the detection of CHDs can be limited by factors such as the sonographer's skill, expertise and patient specific variables. Using artificial intelligence (AI) has the potential to address these challenges, increasing antenatal CHD detection during prenatal care. A scoping review was conducted using Google Scholar, PubMed, and ScienceDirect databases, employing keywords, Boolean operators, and inclusion and exclusion criteria to identify peer-reviewed studies. Thematic mapping and synthesis of the found literature were conducted to review key concepts, research methods and findings. A total of n = 233 articles were identified, after exclusion criteria, the focus was narrowed to n = 7 that met the inclusion criteria. Themes in the literature identified the potential of AI to assist clinicians and trainees, alongside emerging new ethical limitations in ultrasound imaging. AI-based tools in ultrasound imaging offer great potential in assisting sonographers and doctors with decision-making in CHD diagnosis. However, due to the paucity of data and small sample sizes, further research and technological advancements are needed to improve reliability and integrate AI into routine clinical practice. This scoping review identified the reported accuracy and limitations of AI-based tools within foetal cardiac ultrasound imaging. AI has the potential to aid in reducing missed diagnoses, enhance training, and improve pregnancy management. There is a need to understand and address the ethical and legal considerations involved with this new paradigm in imaging.

Large language models (LLMs) are gaining attention for their potential to enhance radiology workflows by addressing challenges such as increasing workloads and staff shortages. However, limited knowledge among radiologists and concerns about their practical implementation and ethical implications present challenges. This study investigates radiologists' perspectives on the use of LLMs, exploring their potential benefits, challenges, and impact on workflows and professional roles. An exploratory, qualitative study was conducted using 12 semi-structured interviews with radiology experts. Data were analyzed to assess participants' awareness, attitudes, and perceived applications of LLMs in radiology. LLMs were identified as promising tools for reducing workloads by streamlining tasks like summarizing clinical histories and generating standardized reports, improving communication and efficiency. Participants expressed openness to LLM integration but noted concerns about their impact on human interaction, ethical standards, and liability. The role of radiologists is expected to evolve with LLM adoption, with a shift toward data stewardship and interprofessional collaboration. Barriers to implementation included limited awareness, regulatory constraints, and outdated infrastructure. The integration of LLMs is hindered by regulatory challenges, outdated infrastructure, and limited awareness among radiologists. Policymakers should establish clear, practical regulations to address liability and ethical concerns while ensuring compliance with privacy standards. Investments in modernizing clinical infrastructure and expanding training programs are critical to enable radiologists to effectively use these tools. By addressing these barriers, LLMs can enhance efficiency, reduce workloads, and improve patient care, while preserving the central role of radiologists in diagnostic and therapeutic processes.

Enthusiasm about the use of artificial intelligence (AI) in medicine has been tempered by concern that algorithmic systems can be unfairly biased against racially minoritized populations. This article uses work on racial disparities in knee osteoarthritis diagnoses to underline that achieving justice in the use of AI in medical imaging requires attention to the entire sociotechnical system within which it operates, rather than isolated properties of algorithms. Using AI to make current diagnostic procedures more efficient risks entrenching existing disparities; a recent algorithm points to some of the problems in current procedures while highlighting systemic normative issues that need to be addressed while designing further AI systems. The article thus contributes to a literature arguing that bias and fairness issues in AI be considered as aspects of structural inequality and injustice and to highlighting ways that AI can be helpful in making progress on these.

Magnetic resonance imaging (MRI) is the gold standard for brain imaging. Deep learning (DL) algorithms have been proposed to aid in the diagnosis of diseases such as Alzheimer's disease (AD) from MRI scans. However, DL algorithms can suffer from shortcut learning, in which spurious features, not directly related to the output label, are used for prediction. When these features are related to protected attributes, they can lead to performance bias against underrepresented protected groups, such as those defined by race and sex. In this work, we explore the potential for shortcut learning and demographic bias in DL based AD diagnosis from MRI. We first investigate if DL algorithms can identify race or sex from 3D brain MRI scans to establish the presence or otherwise of race and sex based distributional shifts. Next, we investigate whether training set imbalance by race or sex can cause a drop in model performance, indicating shortcut learning and bias. Finally, we conduct a quantitative and qualitative analysis of feature attributions in different brain regions for both the protected attribute and AD classification tasks. Through these experiments, and using multiple datasets and DL models (ResNet and SwinTransformer), we demonstrate the existence of both race and sex based shortcut learning and bias in DL based AD classification. Our work lays the foundation for fairer DL diagnostic tools in brain MRI. The code is provided at https://github.com/acharaakshit/ShortMR

Gastric cancer (GC) remains a major global health concern, ranking as the fifth most prevalent malignancy and the fourth leading cause of cancer-related mortality worldwide. Although early detection can increase the 5-year survival rate of early gastric cancer (EGC) to over 90%, more than 80% of cases are diagnosed at advanced stages due to subtle clinical symptoms and diagnostic challenges. Artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), has shown great promise in addressing these limitations. This systematic review aims to evaluate the performance, applications, and limitations of ML and DL models in GC management, with a focus on their use in detection, diagnosis, treatment planning, and prognosis prediction across diverse clinical imaging and data modalities. Following the PRISMA 2020 guidelines, a comprehensive literature search was conducted in MEDLINE, Web of Science, and Scopus for studies published between 2004 and May 2025. Eligible studies applied ML or DL algorithms for diagnostic or prognostic tasks in GC using data from endoscopy, computed tomography (CT), pathology, or multi-modal sources. Two reviewers independently performed study selection, data extraction, and risk of bias assessment. A total of 59 studies met the inclusion criteria. DL models, particularly convolutional neural networks (CNNs), demonstrated strong performance in EGC detection, with reported sensitivities up to 95.3% and Area Under the Curve (AUCs) as high as 0.981, often exceeding expert endoscopists. CT-based radiomics and DL models achieved AUCs ranging from 0.825 to 0.972 for tumor staging and metastasis prediction. Pathology-based models reported accuracies up to 100% for EGC detection and AUCs up to 0.92 for predicting treatment response. Cross-modality approaches combining radiomics and pathomics achieved AUCs up to 0.951. Key challenges included algorithmic bias, limited dataset diversity, interpretability issues, and barriers to clinical integration. ML and DL models have demonstrated substantial potential to improve early detection, diagnostic accuracy, and individualized treatment in GC. To advance clinical adoption, future research should prioritize the development of large, diverse datasets, implement explainable AI frameworks, and conduct prospective clinical trials. These efforts will be essential for integrating AI into precision oncology and addressing the increasing global burden of gastric cancer.

Delivering intensive care in conflict zones and other resource-limited settings presents unique clinical, logistical, and ethical challenges. These contexts, characterized by disrupted infrastructure, limited personnel, and prolonged field care, require adapted strategies to ensure critical care delivery under resource-limited settings. This scoping review aims to identify and characterize medical innovations developed or implemented in recent conflicts that may be relevant and transposable to intensive care units operating in other resource-limited settings. A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Five major databases were searched for English-language publications from 2014 to 2025. Studies describing innovations applicable to intensive care in modern warfare or resource-limited settings were included. While many studies relied on experimental or simulated models, a subset described real-world applications in resource-limited environments, including ultrasound-guided regional analgesia, resuscitative endovascular balloon occlusion of the aorta, portable blood transfusion platforms, and artificial intelligence-supported monitoring of traumatic brain injury. Training strategies such as teleconsultation/telementoring and low-cost simulation were also emphasized. Few of these intensive care innovations were validated in real-life wartime conditions. Innovations from modern warfare offer pragmatic and potentially transposable solutions for intensive care in resource-limited settings. Successfully adapting them requires validation and contextual adaptation, as well as the implementation of concrete collaborative strategies, including tailored training programs, joint simulation exercises, and structured knowledge translation initiatives, to ensure effective and sustainable integration.

Multi-modal medical image fusion (MMIF) is increasingly recognized as an essential technique for enhancing diagnostic precision and facilitating effective clinical decision-making within computer-aided diagnosis systems. MMIF combines data from X-ray, MRI, CT, PET, SPECT, and ultrasound to create detailed, clinically useful images of patient anatomy and pathology. These integrated representations significantly advance diagnostic accuracy, lesion detection, and segmentation. This comprehensive review meticulously surveys the evolution, methodologies, algorithms, current advancements, and clinical applications of MMIF. We present a critical comparative analysis of traditional fusion approaches, including pixel-, feature-, and decision-level methods, and delves into recent advancements driven by deep learning, generative models, and transformer-based architectures. A critical comparative analysis is presented between these conventional methods and contemporary techniques, highlighting differences in robustness, computational efficiency, and interpretability. The article addresses extensive clinical applications across oncology, neurology, and cardiology, demonstrating MMIF's vital role in precision medicine through improved patient-specific therapeutic outcomes. Moreover, the review thoroughly investigates the persistent challenges affecting MMIF's broad adoption, including issues related to data privacy, heterogeneity, computational complexity, interpretability of AI-driven algorithms, and integration within clinical workflows. It also identifies significant future research avenues, such as the integration of explainable AI, adoption of privacy-preserving federated learning frameworks, development of real-time fusion systems, and standardization efforts for regulatory compliance. This review organizes key knowledge, outlines challenges, and highlights opportunities, guiding researchers, clinicians, and developers in advancing MMIF for routine clinical use and promoting personalized healthcare. To support further research, we provide a GitHub repository that includes popular multi-modal medical imaging datasets along with recent models in our shared GitHub repository.