How Explainable Artificial Intelligence Can Increase or Decrease Clinicians' Trust in AI Applications in Health Care: Systematic Review.

BACKGROUND: Artificial intelligence (AI) has significant potential in clinical practice. However, its "black box" nature can lead clinicians to question its value. The challenge is to create sufficient trust for clinicians to feel comfortable using AI, but not so much that they defer to it even when it produces results that conflict with their clinical judgment in ways that lead to incorrect decisions. Explainable AI (XAI) aims to address this by providing explanations of how AI algorithms reach their conclusions. However, it remains unclear whether such explanations foster an appropriate degree of trust to ensure the optimal use of AI in clinical practice. OBJECTIVE: This study aims to systematically review and synthesize empirical evidence on the impact of XAI on clinicians' trust in AI-driven clinical decision-making. METHODS: A systematic review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, searching PubMed and Web of Science databases. Studies were included if they empirically measured the impact of XAI on clinicians' trust using cognition- or affect-based measures. Out of 778 articles screened, 10 met the inclusion criteria. We assessed the risk of bias using standard tools appropriate to the methodology of each paper. RESULTS: The risk of bias in all papers was moderate or moderate to high. All included studies operationalized trust primarily through cognitive-based definitions, with 2 also incorporating affect-based measures. Out of these, 5 studies reported that XAI increased clinicians' trust compared with standard AI, particularly when the explanations were clear, concise, and relevant to clinical practice. In addition, 3 studies found no significant effect of XAI on trust, and the presence of explanations does not automatically improve trust. Notably, 2 studies highlighted that XAI could either enhance or diminish trust, depending on the complexity and coherence of the provided explanations. The majority of studies suggest that XAI has the potential to enhance clinicians' trust in recommendations generated by AI. However, complex or contradictory explanations can undermine this trust. More critically, trust in AI is not inherently beneficial, as AI recommendations are not infallible. These findings underscore the nuanced role of explanation quality and suggest that trust can be modulated through the careful design of XAI systems. CONCLUSIONS: Excessive trust in incorrect advice generated by AI can adversely impact clinical accuracy, just as can happen when correct advice is distrusted. Future research should focus on refining both cognitive and affect-based measures of trust and on developing strategies to achieve an appropriate balance in terms of trust, preventing both blind trust and undue skepticism. Optimizing trust in AI systems is essential for their effective integration into clinical practice.

The role of convalescent plasma and hyperimmune immunoglobulins in the COVID-19 pandemic, including implications for future preparedness.

Introduction: When Coronavirus Disease-19 (COVID-19) struck the world in December 2019, initiatives started to investigate the efficacy of convalescent plasma, a readily available source of passive antibodies, collected from recovered patients as a therapeutic option. This was based on historical observational data from previous virus outbreaks. Methods: A scoping review was conducted on the efficacy and safety of convalescent plasma and hyperimmune immunoglobulins for COVID-19 treatment. This review included the latest Cochrane systematic review update on 30-day mortality and safety. We also covered use in pediatric and immunocompromised patients, as well as the logistic challenges faced in donor recruitment and plasma collection in general. Challenges for low resource countries were specifically highlighted. Results: A major challenge is the high donation frequency required from first-time donors to ensure a safe product, which minimizes the risk of transfusion-transmitted infectious. This is particularly difficult in low- and middle- income countries due to inadequate infrastructure and insufficient blood product supplies. High-certainty evidence indicates that convalescent plasma does not reduce mortality or significantly improve clinical outcomes in patients with moderate to severe COVID-19 infection. However, CCP may provide a viable treatment for patients unable to mount an endogenous immune response to SARS-CoV-2, based on mostly observational studies and subgroup data of published and ongoing randomized trials. Convalescent plasma has been shown to be safe in adults and children with COVID-19 infection. However, the efficacy in pediatric patients remains unclear. Discussion: Data on efficacy and safety of CCP are still underway in ongoing (randomized) studies and by reporting the challenges, limitations and successes encountered to-date, research gaps were identified to be addressed for the future. Conclusion: This experience serves as a valuable example for future pandemic preparedness, particularly when therapeutic options are limited, and vaccines are either being developed or ineffective due to underlying immunosuppression.

Advances and clinical challenges of mesenchymal stem cell therapy.

In recent years, cell therapy has provided desirable properties for promising new drugs. Mesenchymal stem cells are promising candidates for developing genetic engineering and drug delivery strategies due to their inherent properties, including immune regulation, homing ability and tumor tropism. The therapeutic potential of mesenchymal stem cells is being investigated for cancer therapy, inflammatory and fibrotic diseases, among others. Mesenchymal stem cells are attractive cellular carriers for synthetic nanoparticles for drug delivery due to their inherent homing ability. In this review, we comprehensively discuss the various genetic and non-genetic strategies of mesenchymal stem cells and their derivatives in drug delivery, tumor therapy, immune regulation, tissue regeneration and other fields. In addition, we discuss the current limitations of stem cell therapy and the challenges in clinical translation, aiming to identify important development areas and potential future directions.

Phytosomes Nanocarrier with Insight Towards the Future in Cancer Therapy: A Mini-Review.

Cancer is classified as having one of the highest mortality rates on a global scale, presenting a significant challenge in its treatment, especially when conventional chemotherapy methodologies are used. Conversely, there is a growing interest in utilizing herbal medicine as an alternative to the treatment of cancer because of its lack of adverse effects compared to contemporary medical strategies. The incorporation of nanotechnology into therapy has attracted attention owing to its efficacy in the treatment of various illnesses. Phytosomes play a crucial role in the treatment of cancer by enhancing the characteristics of drugs and nanostructures within carriers to enable targeted drug delivery. The establishment of chemical bonds between phospholipid molecules and bioactive compounds from plants ensures the stability of phytosomes, thus establishing them as an innovative mechanism for drug delivery systems that transport plant-derived constituents to specific areas. This mini-overview discusses the potential phytosome complexes, uses, drawbacks, patents, challenges, and prospects of phytosomes in cancer treatment. Thus, numerous phytosomal formulations incorporating plant-derived components have exhibited promising anticancer properties, with several formulations currently undergoing clinical trials.

Controversies regarding transplantation of mesenchymal stem cells.

Mesenchymal stem cells (MSCs) have tantalized regenerative medicine with their therapeutic potential, yet a cloud of controversies looms over their clinical transplantation. This comprehensive review navigates the intricate landscape of MSC controversies, drawing upon 15 years of clinical experience and research. We delve into the fundamental properties of MSCs, exploring their unique immunomodulatory capabilities and surface markers. The heart of our inquiry lies in the controversial applications of MSC transplantation, including the perennial debate between autologous and allogeneic sources, concerns about efficacy, and lingering safety apprehensions. Moreover, we unravel the enigmatic mechanisms surrounding MSC transplantation, such as homing, integration, and the delicate balance between differentiation and paracrine effects. We also assess the current status of clinical trials and the ever-evolving regulatory landscape. As we peer into the future, we examine emerging trends, envisioning personalized medicine and innovative delivery methods. Our review provides a balanced and informed perspective on the controversies, offering readers a clear understanding of the complexities, challenges, and potential solutions in MSC transplantation.

The suboptimal clinical applicability of prognostic prediction models for severe postpartum hemorrhage: a meta-epidemiological study.

OBJECTIVES: To systematically investigate clinical applicability of the current prognostic prediction models for severe postpartum hemorrhage (SPPH). STUDY DESIGN AND SETTING: A meta-epidemiological study of prognostic prediction models was conducted for SPPH. A pre-designed structured questionnaire was adopted to extract the study characteristics, predictors and the outcome, modeling methods, predictive performance, the classification ability for high-risk individuals, and clinical use scenarios. The risk of bias among studies was assessed by the Prediction model Risk Of Bias ASsessment Tool (PROBAST). RESULTS: Twenty-two studies containing 27 prediction models were included. The number of predictors in the final models varied from 3 to 53. However, one-third of the models (11) did not clearly specify the timing of predictor measurement. Calibration was found to be lacking in 10 (37.0%) models. Among the 20 models with an incidence rate of predicted outcomes below 15.0%, none of the models estimated the area under the precision-recall curve, and all reported positive predictive values were below 40.0%. Only two (7.4%) models specified the target clinical setting, while seven (25.9%) models clarified the intended timing of model use. Lastly, all 22 studies were deemed to be at high risk of bias. CONCLUSION: Current SPPH prediction models have limited clinical applicability due to methodological flaws, including unclear predictor measurement, inadequate calibration assessment, and insufficient evaluation of classification ability. Additionally, there is a lack of clarity regarding the timing for model use, target users, and clinical settings. These limitations raise concerns about the reliability and usefulness of these models in real-world clinical practice.

Effect of simulated clinical use and sterilization on the cyclic fatigue resistance of nickel titanium files.

Aim: Assess the effect of simulated clinical use and sterilization on the cyclic fatigue resistance of Race Evo and Tia Tornado Blue nickel titanium (NiTi) files. Materials and Methods: For this study, a total of sixty-four NiTi files were selected, with thirty-two files each from two different manufacturers. Files from each manufacturer were subdivided into four subgroups (n = 8) based on the test parameters. The control groups included files that were neither used nor sterilized. Files from the test groups were used to prepare the root canals of extracted mandibular premolars and then sterilized. This procedure was repeated once, twice, or thrice, depending on the test group. All files were then subjected to a cyclic fatigue test. Data was statistically analyzed using the Kruskal-Wallis and Mann-Whitney U tests. Results: No significant difference was observed in the number of cycles to failure (NCF) among the subgroups for both types of files (P = 0.869 for Tia Tornado Blue, P = 0.626 for Race Evo). Tia Tornado Blue files displayed significantly higher NCF values in the control (P = 0.021), once (P = 0.027), and thrice (P = 0.031) usage groups when compared to Race Evo files. Conclusions: Repeated clinical use and sterilization for up to three cycles did not affect the cyclic fatigue resistance of Race Evo and Tia Tornado Blue files.

On the Feasibility of Using Behavioral Listening Effort Test Methods to Evaluate Auditory Performance in Cochlear Implant Users.

Realistic outcome measures that reflect everyday hearing challenges are needed to assess hearing aid and cochlear implant (CI) fitting. Literature suggests that listening effort measures may be more sensitive to differences between hearing-device settings than established speech intelligibility measures when speech intelligibility is near maximum. Which method provides the most effective measurement of listening effort for this purpose is currently unclear. This study aimed to investigate the feasibility of two tests for measuring changes in listening effort in CI users due to signal-to-noise ratio (SNR) differences, as would arise from different hearing-device settings. By comparing the effect size of SNR differences on listening effort measures with test-retest differences, the study evaluated the suitability of these tests for clinical use. Nineteen CI users underwent two listening effort tests at two SNRs (+4 and +8 dB relative to individuals' 50% speech perception threshold). We employed dual-task paradigms-a sentence-final word identification and recall test (SWIRT) and a sentence verification test (SVT)-to assess listening effort at these two SNRs. Our results show a significant difference in listening effort between the SNRs for both test methods, although the effect size was comparable to the test-retest difference, and the sensitivity was not superior to speech intelligibility measures. Thus, the implementations of SVT and SWIRT used in this study are not suitable for clinical use to measure listening effort differences of this magnitude in individual CI users. However, they can be used in research involving CI users to analyze group data.

Applications of Diffusion-Weighted MRI to the Musculoskeletal System.

Diffusion-weighted imaging (DWI) is an established MRI technique that can investigate tissue microstructure at the scale of a few micrometers. Musculoskeletal tissues typically have a highly ordered structure to fulfill their functions and therefore represent an optimal application of DWI. Even more since disruption of tissue organization affects its biomechanical properties and may indicate irreversible damage. The application of DWI to the musculoskeletal system faces application-specific challenges on data acquisition including susceptibility effects, the low T2 relaxation time of most musculoskeletal tissues (2-70 msec) and the need for sub-millimetric resolution. Thus, musculoskeletal applications have been an area of development of new DWI methods. In this review, we provide an overview of the technical aspects of DWI acquisition including diffusion-weighting, MRI pulse sequences and different diffusion regimes to study tissue microstructure. For each tissue type (growth plate, articular cartilage, muscle, bone marrow, intervertebral discs, ligaments, tendons, menisci, and synovium), the rationale for the use of DWI and clinical studies in support of its use as a biomarker are presented. The review describes studies showing that DTI of the growth plate has predictive value for child growth and that DTI of articular cartilage has potential to predict the radiographic progression of joint damage in early stages of osteoarthritis. DTI has been used extensively in skeletal muscle where it has shown potential to detect microstructural and functional changes in a wide range of muscle pathologies. DWI of bone marrow showed to be a valuable tool for the diagnosis of benign and malignant acute vertebral fractures and bone metastases. DTI and diffusion kurtosis have been investigated as markers of early intervertebral disc degeneration and lower back pain. Finally, promising new applications of DTI to anterior cruciate ligament grafts and synovium are presented. The review ends with an overview of the use of DWI in clinical routine. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: Stage 3.

The changes of different restriction level adjustments on antibiotic use in China.

This quasi-experimental study aimed to investigate the changes in antibiotic use tailored by adjusting provincial antibiotic restriction lists in China using interrupted time-series analysis from 2013 to 2019. Antibiotic use was assessed as defined daily dose (DDD) per 1000 patients per day. Trends and level changes were analysed with segmented regression. The study identified 19 antibiotic formulations in four provinces with adjusted restriction levels (intervention group) and 110 formulations in the rest provinces without adjustments (comparison group). Antibiotics restriction level changed between two categories: (1) between 'highly-restricted' and 'restricted' and (2) between 'restricted' and 'non-restricted'. Analysis revealed distinct trend changes for antibiotics moving between 'highly-restricted' and 'restricted' (ß = 0.0211, P = 0.003) and 'restricted' to 'highly-restricted' (ß = -0.0039, P = 0.128) compared to the comparison group. After a 2-y adjustment period, when moving from 'restricted' to 'highly-restricted', absolute antibiotic utilisation significantly decreased (P < 0.001), with a relative decrease of 100.8% (P < 0.001) compared to the comparison group. Besides, individual antibiotics with higher consumption displayed greater responsiveness to adjustment. These findings underscore the changes in restriction level adjustments on antibiotics, highlighting antibiotic restriction list policies as crucial tools for antimicrobial stewardship.

Evaluation of a clinically introduced deep learning model for radiotherapy treatment planning of breast cancer.

Deep learning (DL) models are increasingly studied to automate the process of radiotherapy treatment planning. This study evaluates the clinical use of such a model for whole breast radiotherapy. Treatment plans were automatically generated, after which planners were allowed to manually adapt them. Plans were evaluated based on clinical goals and DVH parameters. Thirty-seven of 50plans did fulfill all clinical goals without adjustments. Thirteen of these 37 plans were still adjusted but did not improve mean heart or lung dose. These results leave room for improvement of both the DL model as well as education on clinically relevant adjustments.

Oral ketamine may offer a solution to the ketamine conundrum.

Ketamine has received considerable attention for its rapid and robust antidepressant response over the past decade. Current evidence, in clinical populations, predominantly relates to parenterally administered ketamine, which is reported to produce significant undesirable side effects, with additional concerns regarding long-term safety and abuse potential. Attempts to produce a similar drug to ketamine, without the psychotomimetic side effects, have proved elusive. Orally administered ketamine has a different pharmacological profile to parentally administered ketamine, suggesting it may be a viable alternative. Emerging evidence regarding the efficacy and tolerability of oral ketamine suggests that it may be a favourable route of administration, as it appears to obtain similarly beneficial treatment effects, but without the cost and medical resources required in parenteral dosing. The pharmacological effects may be due to the active metabolite norketamine, which has been found to be at substantially higher levels via oral dosing, most likely due to first-pass clearance. Despite bioavailability and peak plasma concentrations both being lower than when administered parenterally, evidence suggests that low-dose oral ketamine is clinically effective in treating pain. This may also be due to the actions of norketamine and therefore, its relevance to the mental health context is explored in this narrative review.

Implementation of targeted next-generation sequencing for the diagnosis of drug-resistant tuberculosis in low-resource settings: a programmatic model, challenges, and initial outcomes.

Targeted next-generation sequencing (tNGS) from clinical specimens has the potential to become a comprehensive tool for routine drug-resistance (DR) prediction of Mycobacterium tuberculosis complex strains (MTBC), the causative agent of tuberculosis (TB). However, TB mainly affects low- and middle-income countries, in which the implementation of new technologies have specific needs and challenges. We propose a model for programmatic implementation of tNGS in settings with no or low previous sequencing capacity/experience. We highlight the major challenges and considerations for a successful implementation. This model has been applied to build NGS capacity in Namibia, an upper middle-income country located in Southern Africa and suffering from a high-burden of TB and TB-HIV, and we describe herein the outcomes of this process.

Prognostic impact of the Controlling Nutritional Status Score in patients with biliary tract cancer: a systematic review and meta-analysis.

Background: Biliary tract cancer (BTC) is a malignancy associated with unfavorable outcomes. Advanced BTC patients have a propensity to experience compromised immune and nutritional status as a result of obstructive jaundice and biliary inflammation. Currently, there is a lack of consensus on the impact of the Controlling Nutritional Status (CONUT) score in the context of BTC prognosis. The purpose of this study is to conduct a meta-analysis on the association between CONUT and the prognosis of patients suffering from BTC. Methods: A defined search strategy was implemented to search the PubMed, Embase, and Web of Science databases for eligible studies published until March 2023, with a focus on overall survival (OS), relapse-free survival/recurrence-free survival(RFS), and relevant clinical characteristics. The prognostic potential of the CONUT score was evaluated using hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs). Results: In this meta-analysis, a total of 1409 patients from China and Japan were involved in 9 studies. The results indicated that the CONUT score was significantly correlated with worse OS (HR=2.13, 95% CI 1.61-2.82, P<0.0001) and RFS (HR=1.83, 95% CI 1.44-2.31, P<0.0001) in patients with BTC. And, the analysis showed that a high CONUT score was significantly associated with clinical characteristics such as jaundice (OR=1.60, 95% CI=1.14-2.25, P=0.006), poorly differentiated tumor (OR=1.43, 95% CI=1.03-1.99, P=0.03), pT3 and 4 stage of the tumor (OR=1.87, 95% CI=1.30-2.68, P=0.0007), and complications of Clavien-Dindo classification grade IIIa or higher (OR=1.79, 95% CI=1.03-3.12, P=0.04). Conclusion: This meta-analysis indicates that a high CONUT score can serve as a significant prognostic indicator for survival outcomes among patients diagnosed with BTC.

Pulsed Electromagnetic Fields (PEMF)-Physiological Response and Its Potential in Trauma Treatment.

Environmental biophysical interactions are recognized to play an essential part in the human biological processes associated with trauma recovery. Many studies over several decades have furthered our understanding of the effects that Pulsed Electromagnetic Fields (PEMF) have on the human body, as well as on cellular and biophysical systems. These investigations have been driven by the observed positive clinical effects of this non-invasive treatment on patients, mainly in orthopedics. Unfortunately, the diversity of the various study setups, with regard to physical parameters, molecular and cellular response, and clinical outcomes, has made it difficult to interpret and evaluate commonalities, which could, in turn, lead to finding an underlying mechanistic understanding of this treatment modality. In this review, we give a birds-eye view of the vast landscape of studies that have been published on PEMF, presenting the reader with a scaffolded summary of relevant literature starting from categorical literature reviews down to individual studies for future research studies and clinical use. We also highlight discrepancies within the many diverse study setups to find common reporting parameters that can lead to a better universal understanding of PEMF effects.

Real-world effectiveness of benralizumab in US subspecialist-treated adults with severe asthma: Findings from CHRONICLE.

BACKGROUND: Patients with eosinophilic severe asthma (SA) have an increased risk of asthma exacerbations. Benralizumab is approved for eosinophilic SA, and there is great value in understanding real-world effectiveness. OBJECTIVE: The aim of this analysis was to examine the effectiveness of benralizumab in a real-world cohort of subspecialist-treated US patients with eosinophilic SA. METHODS: CHRONICLE is an ongoing, noninterventional study of subspecialist-treated US adults with SA receiving biologics, maintenance systemic corticosteroids, or those persistently uncontrolled by high-dose inhaled corticosteroids with additional controllers. For this analysis, eligible patients enrolled from February 2018 to February 2021, had received ≥ 1 dose of benralizumab, and had study data for ≥ 3 months before and after benralizumab initiation. The primary analysis included patients with prior exacerbations reported and 12 months of outcomes data before and after initiation. Patient outcomes occurring 6-12 months before and after initiation were also evaluated. RESULTS: A total of 317 patients had ≥ 3 months of follow-up before and after first benralizumab dose. For patients with 12 months (n = 107) and 6-12 months (n = 166) of data, significant reductions were observed in annualized rates of exacerbations (62%; P < 0.001 and 65%; P < 0.001, respectively), with similar reductions in the rates of hospitalizations and emergency department visits. Benralizumab recipients with blood eosinophil counts (BEC) of ≥ 300/ µL and < 300/ µL at baseline and 12 months of data also had significant reductions in exacerbations (68%; P < 0.001, 61%; P < 0.001). CONCLUSION: This real-world, noninterventional analysis reinforces the clinical value of benralizumab in the management of patients with eosinophilic SA.

Gabapentin: Clinical Use and Pharmacokinetics in Dogs, Cats, and Horses.

Gabapentin is an anticonvulsant drug, which presents an established clinical efficacy in human patients for the management of refractory partial seizures, secondarily generalized tonic-clonic seizures, and for the control of chronic neuropathic pain. Gabapentin was synthesized as a structural analogue of the inhibitory neurotransmitter GABA, with GABA-mimetic effects, able to cross the blood-brain barrier. In veterinary medicine, is extra-label used in combination with other treatments to control seizures when other drugs are no longer effective or become toxic or for neuropathic pain treatment and anxiety. This review aimed to clarify gabapentin use and pharmacokinetic aspects to promote conscious use in dogs, cats, and horses. In dogs, gabapentin was beneficial in the treatment of epilepsy, as well as chronic, neuropathic, and post-operative pain, as well as anxiety. In cats, it showed efficacy in post-ovariohysterectomy-related pain and in anxiety management. In horses, gabapentin has been administered as an analgesic for chronic pain management. In conclusion, when used in combination with other drugs, gabapentin can be considered an interesting therapeutic option for the treatment of neuropathic diseases and analgesia in postoperative and chronic pain. However, despite its beneficial use in different clinical settings, further trials and pharmacokinetic studies are needed for the definition of an effective dosage regimen through proper pharmacokinetic/pharmacodynamic correlation in dogs, cats, and horses.

Glycyrrhizae Radix et Rhizoma: The popular occurrence of herbal medicine applied in classical prescriptions.

Glycyrrhizae Radix et Rhizoma is a well-known herbal medicine with a wide range of pharmacological functions that has been used throughout Chinese history. This review presents a comprehensive introduction to this herb and its classical prescriptions. The article discusses the resources and distribution of species, methods of authentication and determination chemical composition, quality control of the original plants and herbal medicines, dosages use, common classical prescriptions, indications, and relevant mechanisms of the active content. Pharmacokinetic parameters, toxicity tests, clinical trials, and patent applications are discussed. The review will provide a good starting point for the research and development of classical prescriptions to develop herbal medicines for clinical use.

Potency Assay Development: A Keystone for Clinical Use.

Potency can be described as the quantitative measure of biological activity, that is, the ability of an Advanced Therapy Medicinal Product (ATMP) to elicit the intended effect necessary for clinical efficacy. Potency testing is part of the quality control strategy necessary for batch release and is required for market approval application of an ATMP. Thus, it is crucial to develop a reliable and accurate potency assay. As a prerequisite for potency assay development, it is essential to define the mode of action of the product and thereby also the relevant biological activity that should be measured. The establishment of a potency assay should be initiated already during early product development followed by its progressive implementation into an ATMP's manufacturing, quality control and release process. Potency testing is indispensable for clinical use with a wide range of applications. A potency assay is a valuable tool to determine the product's stability, detect the impact of changes in the manufacturing process on the product, demonstrate quality and manufacturing consistency from batch to batch, estimate clinical efficacy and define the effective dose. This chapter describes the requirements and challenges to be considered for potency assay development and the importance of a well-established potency assay for clinical use.

A Systematic Review of Clinical Pharmacokinetics of Inhaled Antiviral.

Background and Objectives: The study of clinical pharmacokinetics of inhaled antivirals is particularly important as it helps one to understand the therapeutic efficacy of these drugs and how best to use them in the treatment of respiratory viral infections such as influenza and the current COVID-19 pandemic. The article presents a systematic review of the available pharmacokinetic data of inhaled antivirals in humans, which could be beneficial for clinicians in adjusting doses for diseased populations. Materials and Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive literature search was conducted using multiple databases, and studies were screened by two independent reviewers to assess their eligibility. Data were extracted from the eligible studies and assessed for quality using appropriate tools. Results: This systematic review evaluated the pharmacokinetic parameters of inhaled antiviral drugs. The review analyzed 17 studies, which included Zanamivir, Laninamivir, and Ribavirin with 901 participants, and found that the non-compartmental approach was used in most studies for the pharmacokinetic analysis. The outcomes of most studies were to assess clinical pharmacokinetic parameters such as the Cmax, AUC, and t1/2 of inhaled antivirals. Conclusions: Overall, the studies found that the inhaled antiviral drugs were well tolerated and exhibited favorable pharmacokinetic profiles. The review provides valuable information on the use of these drugs for the treatment of influenza and other viral respiratory infections.