In Reply We sincerely appreciate the supportive comments provided by Bignami et al about our Viewpoint. We agree that the concept we highlighted, namely, use of artificial intelligence (AI)–informed clinical decision support systems to guide de-escalation of care in intensive care units, can be applied broadly across all age groups.
Moreover, for this approach to impact clinical outcome measures at the health care system level, we believe that collaboration, transparency, and data sharing between centers are key. Furthermore, we advocate for international adoption of this approach but realize that low- and middle-income countries may not have sufficient infrastructure and resources to adopt predictive analytics models in their health care systems.
As we mentioned in our Viewpoint, implementation of AI models in intensive care units is presently scarce. We hope that shifting the focus to the de-escalation phase will lead to increased use of these models—an opportunity for prospective multicenter clinical studies to test a wide range of AI driven clinical decision support algorithms, as well as analytics-driven, simulation-based digital twins.
JAMA Pediatrics published a clinical update in Research Highlights on 06 Apr 2026.
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