Inteligencia artificial en la toma de decisiones clínicas: revisión sistemática con síntesis narrativa de la literatura publicada entre 2019 y 2026
DOI:
https://doi.org/10.65133/irj.v2.n1.2026/a19Palabras clave:
inteligencia artificial, toma de decisiones clínicas, sistemas de apoyo a la decisión clínica, modelos de lenguaje de gran tamaño, revisión sistemática, seguridad del pacienteResumen
Introducción: la inteligencia artificial (IA) se incorpora con rapidez al apoyo de las decisiones clínicas, pero la evidencia sobre su utilidad y sus riesgos está dispersa. Objetivo: analizar la influencia de la IA en la toma de decisiones clínicas entre 2019 a marzo de 2026: su utilidad, sus desafíos y oportunidades y su aporte a la atención del paciente. Metodología: revisión sistemática con síntesis narrativa en dos fases, según PRISMA 2020. La primera fase (2019 a 2023) buscó en Web of Science, Scopus, PubMed y Springer Link, y la actualización (2024 a marzo de 2026) en el Directorio de Revistas de Acceso Abierto. La calidad se valoró con diez criterios (corte en 7,5 de 10). Resultados: se incluyeron 63 registros (62 estudios), 26 de la primera fase y 37 de la actualización. Frente a una primera fase descriptiva, la actualización aportó estudios primarios, entre ellos cinco ensayos aleatorizados y ocho con modelos de lenguaje. La IA mejoró la detección de cáncer, la auscultación y la rapidez de algunas decisiones, pero no siempre el razonamiento diagnóstico, y se documentaron dependencia inadecuada, falsos positivos y pérdida de habilidades. Los profesionales piden validación, transparencia, integración en la historia clínica y claridad sobre la responsabilidad. No hubo estudios latinoamericanos. Conclusiones: la IA es un apoyo útil cuando se valida en su contexto y se usa bajo supervisión médica, y su beneficio depende de cómo se integra en el trabajo clínico. Hacen falta ensayos con desenlaces en pacientes y estudios en Latinoamérica.
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