Applying a Novel Approach to Scoping Review Incorporating Artificial Intelligence: Mapping the Natural History of Gonorrhoea

Background: This scoping review presents the results of three distinct search strategies combined to identify and map the range of conditions (clinical presentations, complications, coinfections and health problems) associated with gonorrhoea infection. We also report use of a novel artificial-intelligence-(AI)-assisted Medline search tool. Methods: To fully characterize the range of health outcomes associated with gonorrhoea, we combined a structured preliminary search with a traditional systematic search, then supplemented with the output of a novel AI-assisted Medline search to identify eligible literature. Results: We identified 189 health conditions associated with gonorrhoea infection from107 unique references and 21 International Statistical Classification of Diseases and Related Health Problems Ninth and Tenth Revision (ICD 9/10) or Read codes. Pathogenic processes relating to these outcomes were also briefly summarized. The 189 identified health conditions were related to infection of the urogenital tract (n=86), anorectal tract (n=6) oropharyngeal tract (n=5) and the eye (n=14); and other conditions such as systemic (n=61) and neonatal conditions (n=7), psychosocial associations (n=3), and co-infections (n=7). The 107 unique references attained a Scottish Intercollegiate Guidelines Network (SIGN) score of ≥2++ (n=2), 2+ (14 [13%]), 2- (30 [28%]) and 3 (45 [42%]), respectively. Remaining papers (n=16) were reviews. Conclusions: Through AI screening of Medline, we captured – titles, abstracts, case reports and case series related to rare but serious health conditions. These outcomes might otherwise have been missed during a systematic search. The AI-assisted search provided a useful addition to traditional/manual literature searches especially when rapid results are required.