An overview of clinical machine learning applications in neurology.

Machine learning techniques for clinical applications are evolving, and the potential impact this will have on clinical neurology is important to recognize. By providing a broad overview on this growing paradigm of clinical tools, this article aims to help healthcare professionals in neurology prepare to navigate both the opportunities and challenges brought on through continued advancements in machine learning. This narrative review first elaborates on how machine learning models are organized and implemented. Machine learning tools are then classified by clinical application, with examples of uses within neurology described in more detail. Finally, this article addresses limitations and considerations regarding clinical machine learning applications in neurology.

World Brain Day 2023 - Brain Health and Disability: "Leave no one behind".

Worldwide, the number of persons with disability is assumed to be around 1.3 billion. Although several definitions exist, such as the medical and social models, the social model has more holistic approaches and engulfs more aspects. Historically, many considerations were based on eugenics until the middle of the 20th century when a change of paradigm occurred, and disability has since been subject to many developments in the past decades. Previously dependent on mercy and good will, disability has now become a human right, and the implementation of this change is still ongoing. Neurological diseases contribute worldwide to a large proportion of disability and can be classified as reversible or permanent, by their time course, and by disease specific elements. Addtionally, neurological diseases are often accepted and managed differently across cultures and are exposed to variable degrees of stigma. The World Federation of Neurology (WFN) has initiated and continues to promote the concept of brain health, which has a wide range of inclusion and is best summarized in the World Health Organization paper (World Health Organization, 2022a). This concept is embedded in the Intersectoral Global Action Plan (IGAP) (World Health Organization, 2022b), which created a global tool to promote neurology, and the WFN is using this tool for the 2023 World Brain Day to promote and introduce the concept of disability.

Development and Results of the First Certification Examination in the American Board of Medical Specialties Neurocritical Care Subspecialty.

This article reviews the development of the American Board of Medical Specialties subspecialty in neurocritical care (NCC) and describes the requirements for certification and the results of the first certification examination administered in October 2021. The American Board of Psychiatry and Neurology (ABPN) is the administrative board, and the sponsoring boards are the American Board of Anesthesiology (ABA), American Board of Emergency Medicine (ABEM), American Board of Internal Medicine (ABIM), and American Board of Neurological Surgery. The American Board of Medical Specialties approved the subspecialty in 2018, and the Accreditation Council for Graduate Medical Education developed and approved the training requirements in 2021. The fellowship programs are either 12 or 24 months in length and may become available in Academic Year 2022-2023. The first NCC examination was developed by a multispecialty group of subject matter experts following established test development procedures and was successfully administered to 1,011 candidates in October 2021. There were 406 (40.2%) ABIM candidates, 356 (35.2%) ABPN candidates, 208 (20.6%) ABA candidates, and 41 (4.1%) ABEM candidates. The end-of-test survey indicated that most examinees were satisfied with their test taking experience, and the .92 reliability index indicated that the test scores were reliable. An established process was also followed to set the criterion-referenced passing standard, and the resulting pass rate of 72.7% was judged to be reasonable. In summary, the combined efforts of representatives from the ABPN, ABA, ABEM, ABIM, and American Board of Neurological Surgery yielded a quality assessment instrument to identify physicians who possess the expertise required to be certified in NCC. The test development committee will continue to expand and improve the pool of test questions for the next examination, which is scheduled for October 2022.

An Article-Based Format for Medical Specialty and Subspecialty Maintenance of Certification.

INTRODUCTION: This article describes an article-based alternative for maintenance of certification that the American Board of Psychiatry and Neurology developed and began pilot testing in 2019. The rationale for and components of the pilot program are presented along with data on participant performance and feedback from the first year of implementation in three primary specialties (neurology, child neurology, and psychiatry) and one subspecialty (child and adolescent psychiatry). METHODS: Evaluation of the pilot program was guided by a widely used validity framework. Data were collected that addressed the five categories of validity evidence: content, response process, internal structure, relation to other variables, and consequences. RESULTS: Enrollment ranged from 66.7% for psychiatrists to 75.3% for child neurologists. For the 2019 cohort, the pass rates ranged from 92.6% for child and adolescent psychiatry to 98.7% for neurology, and very small numbers of diplomates failed or did not complete the process. For psychiatrists, there was a modest, but significant, relationship between performance on previous and subsequent maintenance of certification examinations. Ninety percent or more agreed that: the articles were easy to access and helpful to their practices; the mini-tests were a fair assessment of their understanding of the articles; and their test-taking experience was satisfactory. DISCUSSION: Most eligible diplomates participated in the article-based pilot project, and they strongly preferred this format to the traditional multiple-choice examinations. Most important, the pilot was perceived to be a meaningful and relevant learning activity that had a positive effect on patient care.