A smartphone based AI model to detect left ventricular systolic dysfunction on 12-lead ECG

Artificial Intelligence: The Future of Maxillofacial Prognosis and Diagnosis?

Real-World Surveillance of FDA-Cleared Artificial Intelligence Models: Rationale and Logistics.

Focused cardiac ultrasound (FoCUS) is becoming standard practice in a wide spectrum of clinical settings. There is limited data evaluating the real-world use of FoCUS with artificial intelligence (AI). Our objective was to determine the accuracy of FoCUS AI-assisted left ventricular ejection fraction (LVEF) assessment and compare its accuracy between novice and experienced users. In this prospective, multicentre study, participants requiring a transthoracic echocardiogram (TTE) were recruited to have a FoCUS done by a novice or experienced user. The AI-assisted device calculated LVEF at the bedside, which was subsequently compared to TTE. 449 participants were enrolled with 424 studies included in the final analysis. The overall intraclass coefficient was 0.904, and 0.921 in the novice (n = 208) and 0.845 in the experienced (n = 216) cohorts. There was a significant bias of 0.73% towards TTE (p = 0.005) with a level of agreement of 11.2%. Categorical grading of LVEF severity had excellent agreement to TTE (weighted kappa = 0.83). The area under the curve (AUC) was 0.98 for identifying an abnormal LVEF (<50%) with a sensitivity of 92.8%, specificity of 92.3%, negative predictive value (NPV) of 0.97 and a positive predictive value (PPV) of 0.83. In identifying severe dysfunction (<30%) the AUC was 0.99 with a sensitivity of 78.1%, specificity of 98.0%, NPV of 0.98 and PPV of 0.76. Here we report that FoCUS AI-assisted LVEF assessments provide highly reproducible LVEF estimations in comparison to formal TTE. This finding was consistent among senior and novice echocardiographers suggesting applicability in a variety of clinical settings.

Effect of Guideline-Based Therapy on Left Ventricular Systolic Function Recovery After ST-Segment Elevation Myocardial Infarction

Left ventricular opacification (LVO) improves the accuracy of left ventricular ejection fraction (LVEF) by enhancing the visualization of the endocardium. Manual delineation of the endocardium by sonographers has observer variability. Artificial intelligence (AI) has the potential to improve the reproducibility of LVO to assess LVEF. The aim was to develop an AI model and evaluate the feasibility and reproducibility of LVO in the assessment of LVEF. This retrospective study included 1305 echocardiography of 797 patients who had LVO at the Department of Ultrasound Medicine, Union Hospital, Huazhong University of Science and Technology from 2013 to 2021. The AI model was developed by 5-fold cross validation. The validation datasets included 50 patients prospectively collected in our center and 42 patients retrospectively collected in the external institution. To evaluate the differences between LV function determined by AI and sonographers, the median absolute error (MAE), spearman correlation coefficient, and intraclass correlation coefficient (ICC) were calculated. In LVO, the MAE of LVEF between AI and manual measurements was 2.6% in the development cohort, 2.5% in the internal validation cohort, and 2.7% in the external validation cohort. Compared with two-dimensional echocardiography (2DE), the left ventricular (LV) volumes and LVEF of LVO measured by AI correlated significantly with manual measurements. AI model provided excellent reliability for the LV parameters of LVO (ICC > 0.95). AI-assisted LVO enables more accurate identification of the LV endocardium and reduces observer variability, providing a more reliable way for assessing LV function.

PO-04-206 THE TRANSFERABLE ARTIFICIAL INTELLIGENT MODEL BASED ON ELECTROCARDIOGRAM: A PROSPECTIVE OBSERVATIONAL STUDY TOWARD HOME-BASED APPLICATION OF SINGLE-LEAD ECG IN IDENTIFYING HEART FAILURE WITH LOW LEFT VENTRICULAR EJECTION FRACTION

Aim: The majority of machine learning (ML) models in healthcare are built on retrospective data, much of which is collected without explicit patient consent for use in artificial intelligence (AI) and ML applications. The primary aim of this study was to evaluate whether clinicians and scientific researchers themselves consent to provide their own data for the training of ML models. Materials and Methods: This survey was conducted through an anonymous online survey, utilizing platforms such as Telegram, LinkedIn, and Viber. The target audience comprised specific international groups, primarily Russian, German, and English-speaking, of clinicians and scientific researchers. These participants ranged in their levels of expertise and experience, from beginners to veterans. The survey centered on a singular, pivotal question: “Do You Consent to the Use of Your Biological and Private Data for Training Machine Learning and AI Models?” Respondents had the option to choose from three responses: “Yes” and “No”. Results: The survey was conducted in January 2024. A total of 119 unique and verified individuals participated in the survey. The results revealed that only 50% of respondents (63 persons) expressed consent to provide their own data for the training of ML and AI models. Conclusion: In the development of ML and AI models, particularly open-source ones, it is crucial to ascertain whether participants are willing to provide their private data. While ML algorithms can transform the nature of data, it is important to remember that the primary owner of this data is the individual. Our findings show that in 50% of the cases, even participants from scientific research and clinical backgrounds – individuals typically accountable for ensuring data quality in AI and ML model development – do not consent to the use of their data in AI and ML settings. This highlights the need for more stringent consent processes and ethical considerations in the utilization of personal data in AI and ML research.

Although the goal of rectal cancer treatment is to restore gastrointestinal continuity, some patients with rectal cancer develop a permanent stoma (PS) after sphincter-saving operations. Although many studies have identified the risk factors and causes of PS, few have precisely predicted the probability of PS formation before surgery. To validate whether an artificial intelligence model can accurately predict PS formation in patients with rectal cancer after sphincter-saving operations. Patients with rectal cancer who underwent a sphincter-saving operation at Taipei Medical University Hospital between January 1, 2012, and December 31, 2021, were retrospectively included in this study. A machine learning technique was used to predict whether a PS would form after a sphincter-saving operation. We included 19 routinely available preoperative variables in the artificial intelligence analysis. To evaluate the efficiency of the model, 6 performance metrics were utilized: accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiving operating characteristic curve. In our classification pipeline, the data were randomly divided into a training set (80% of the data) and a validation set (20% of the data). The artificial intelligence models were trained using the training dataset, and their performance was evaluated using the validation dataset. Synthetic minority oversampling was used to solve the data imbalance. A total of 428 patients were included, and the PS rate was 13.6% (58/428) in the training set. The logistic regression (LR), Gaussian Naïve Bayes (GNB), Extreme Gradient Boosting (XGB), Gradient Boosting (GB), random forest, decision tree and light gradient boosting machine (LightGBM) algorithms were employed. The accuracies of the logistic regression (LR), Gaussian Naïve Bayes (GNB), Extreme Gradient Boosting (XGB), Gradient Boosting (GB), random forest (RF), decision tree (DT) and light gradient boosting machine (LightGBM) models were 70%, 76%, 89%, 93%, 95%, 79% and 93%, respectively. The area under the receiving operating characteristic curve values were 0.79 for the LR model, 0.84 for the GNB, 0.95 for the XGB, 0.95 for the GB, 0.99 for the RF model, 0.79 for the DT model and 0.98 for the LightGBM model. The key predictors that were identified were the distance of the lesion from the anal verge, clinical N stage, age, sex, American Society of Anesthesiologists score, and preoperative albumin and carcinoembryonic antigen levels. Integration of artificial intelligence with available preoperative data can potentially predict stoma outcomes after sphincter-saving operations. Our model exhibited excellent predictive ability and can improve the process of obtaining informed consent.

CORRELATION BETWEEN PEAK MITRAL ANNULAR SYSTOLIC VELOCITY AND LEFT VENTRICULAR EJECTION FRACTION IN SEPSIS AND SEPTIC SHOCK

This study aims at evaluating if ChatGPT-based artificial intelligence (AI) models are effective in interpreting electrocardiograms (ECGs) and determine their accuracy as compared to those of cardiologists. The purpose is therefore to explore if ChatGPT can be employed for clinical setting, particularly where there are no available cardiologists. A total of 107 ECG cases classified according to difficulty (simple, intermediate, complex) were analyzed using three AI models (GPT-ECGReader, GPT-ECGAnalyzer, GPT-ECGInterpreter) and compared with the performance of two cardiologists. The statistical analysis was conducted using chi-square and Fisher exact tests using scikit-learn library in Python 3.8. Cardiologists demonstrated superior accuracy (92.52%) compared to ChatGPT-based models (GPT-ECGReader: 57.94%, GPT-ECGInterpreter: 62.62%, GPT-ECGAnalyzer: 62.62%). Statistically significant differences were observed between cardiologists and AI models (p < 0.05). ChatGPT models exhibited enhanced performance with female patients; however, the differences found were not statistically significant. Cardiologists significantly outperformed AI models across all difficulty levels. When it comes to diagnosing patients with arrhythmia (A) and cardiac structural disease ECG patterns, cardiologists gave the best results though there was no statistical difference between them and AI models in diagnosing people with normal (N) ECG patterns. ChatGPT-based models have potential in ECG interpretation; however, they currently lack adequate reliability beyond oversight from a doctor. Additionally, further studies that would improve the accuracy of these models, especially in intricate diagnoses are needed.

BackgroundAlthough capsule endoscopy (CE) is a crucial tool for diagnosing small bowel diseases, the need to process a vast number of images imposes a significant workload on physicians, leading to a high risk of missed diagnoses. This study aims to develop an artificial intelligence (AI) model and application based on convolutional neural networks that can automatically recognize various lesions in small bowel capsule endoscopy.MethodsThree small bowel capsule endoscopy datasets were used for AI model training, validation, and testing, encompassing 12 categories of images. The model’s performance was evaluated using metrics such as AUC, sensitivity, specificity, precision, accuracy, and F1 score to select the best model. A human-machine comparison experiment was conducted using the best model and endoscopists with varying levels of experience. Model interpretability was analyzed using Grad-CAM and SHAP techniques. Finally, a clinical application was developed based on the best model using PyQt5 technology.ResultsA total of 34,303 images were included in this study. The best model, MobileNetv3-large, achieved a weighted average sensitivity of 87.17%, specificity of 98.77%, and an AUC of 0.9897 across all categories. The application developed based on this model performed exceptionally well in comparison with endoscopists, achieving an accuracy of 87.17% and a processing speed of 75.04 frames per second, surpassing endoscopists of varying experience levels.ConclusionThe AI model and application developed based on convolutional neural networks can quickly and accurately identify 12 types of small bowel lesions. With its high sensitivity, this system can effectively assist physicians in interpreting small bowel capsule endoscopy images.Future studies will validate the AI system for video evaluations and real-world clinical integration.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12876-024-03482-7.

Statement of problem: Artificial intelligence (AI) applications are increasingly used in restorative process. But existing dentistry restoration effectiveness as well as growth and IA applications have not yet been systematically analyzed or documented. Purpose: The goal of such comprehensive evaluation is to discover &amp; assess the abilities associated with artificial intelligence models in restorative dentistry for the analysis of caries as well as vertical tooth fracture, evaluate margins in preparing tooth, and analyze reconstructive failures. Methods: A systematic electronic review of 5 databases was carried out: PubMed/ MEDLINE, World of Science, EMBASE, Scopus and Cochrane. The investigation was carried out manually as well. Research using AI models was chosen on the basis of 4 criterion: dental caries diagnostics, diagnostics, vertical tooth fracture, tooth preparation recognition, &amp; cause of failure of restoration. Both researchers rated the quality of the study for Critical Appraisal Checklist for Quasi-Experimental Studies (nonrandomized experimental studies). The 3rd author was asked for resolving the dispute. Results: 34 researches were made the part of this analysis: from which 29 contains artificial intelligence techniques including the diagnostics or treatment related to caries and its causes according to sensitivity models, 2 to diagnose vertical tooth fractures, 1 to prepare the teeth. Among the studied analysis, the accuracy of caries diagnosis in the AI models was tested from 76-88.3%, sensitivity from 73-90%, as well as specificity from 61.5-93%. In the study, the accuracy of predicted caries ranges from 83.6-97.1%. The performed research showed the accuracy of the analysis of a vertical tooth fracture from 88.3-95.7%. The study, which uses AI models to find a destination, had details with the range of 90.6-97.4%. Conclusions: AI models are a powerful tool for diagnosing caries as well as vertical tooth fractures, recognizing preparation margins and predicting restoration failures. But, the dental use of AI models continues to evolve. More research is needed to evaluate the clinical effectiveness of artificial intelligence models in restorative dentistry. Keyword: Artificial intelligence, restorative dentistry, vertical tooth fractures.

This study evaluated if medical doctors could identify more hemorrhage events during chart review in a clinical setting when assisted by an artificial intelligence (AI) model and medical doctors' perception of using the AI model. To develop the AI model, sentences from 900 electronic health records were labeled as positive or negative for hemorrhage and categorized into one of 12 anatomical locations. The AI model was evaluated on a test cohort consisting of 566 admissions. Using eye-tracking technology, we investigated medical doctors' reading workflow during manual chart review. Moreover, we performed a clinical use study where medical doctors read two admissions with and without AI assistance to evaluate performance when using and perception of using the AI model. The AI model had a sensitivity of 93.7% and a specificity of 98.1% on the test cohort. In the use studies, we found that medical doctors missed more than 33% of relevant sentences when doing chart review without AI assistance. Hemorrhage events described in paragraphs were more often overlooked compared with bullet-pointed hemorrhage mentions. With AI-assisted chart review, medical doctors identified 48 and 49 percentage points more hemorrhage events than without assistance in two admissions, and they were generally positive toward using the AI model as a supporting tool. Medical doctors identified more hemorrhage events with AI-assisted chart review and they were generally positive toward using the AI model.

Quantum computing (QC) is not a futuristic notion in agriculture, though its full potential has yet to be realized. QC is an emerging field at the intersection of physics and computer science that holds immense potential to revolutionize various sectors, including agriculture production and artificial intelligence (AI) modeling. While QC is still in the early stages of development and practical applications within agriculture are not yet widespread, researchers are actively exploring its potential benefits in various agricultural domains, including crop optimization, livestock breeding, and environmental monitoring. QC harnesses the principles of quantum mechanics to perform computations using quantum bits or qubits, which can exist in multiple states simultaneously. Unlike classical computers, which rely on binary bits representing 0 or 1, quantum computers exploit phenomena such as superposition and entanglement to process information in parallel, potentially offering exponential speedup for certain types of problems. In agriculture production, particularly in animal science, QC offers promising avenues for optimizing processes and enhancing productivity. Quantum algorithms can analyze vast amounts of genomic data to improve breeding programs, leading to the development of more resilient and productive livestock breeds. Furthermore, QC can facilitate precision farming techniques by modeling complex environmental factors and animal behavior to optimize feeding strategies, disease management, and overall farm management practices. Moreover, QC can significantly benefit AI modeling by accelerating computations and enabling more efficient training of AI models. Quantum algorithms can enhance the performance of AI algorithms in various tasks, including pattern recognition, natural language processing, and predictive analytics. By leveraging quantum-enhanced optimization algorithms, AI models can achieve better convergence and accuracy, leading to more effective decision-making and problem-solving capabilities. While hybrid intelligent models also represent a novel frontier in agriculture, QC has the potential to expedite the merging of mechanistic and AI modeling paradigms, facilitating a more holistic understanding of complex systems in agriculture and beyond. By integrating mechanistic models, which describe the underlying physical processes, with AI models, which learn patterns from data, quantum computing can enable comprehensive simulations and predictions of agricultural systems. This fusion of modeling paradigms can lead to more accurate and robust predictions of crop yields, livestock performance, and environmental impacts, facilitating informed decision-making for farmers and policymakers. The application of QC in agriculture, however, requires interdisciplinary collaborations between physicists, computer scientists, agronomists/animal scientists, and AI researchers. These collaborations can drive the development of quantum algorithms tailored to agricultural applications, the integration of quantum-enhanced AI techniques into existing modeling frameworks, and the deployment of QC resources in real-world agricultural systems. Ultimately, harnessing the power of QC holds the potential to revolutionize agriculture production practices, including regenerative agriculture, and advance AI modeling capabilities, paving the way for a more sustainable and efficient agricultural industry.

Background Current approaches utilizing non-invasive methods to screen for cardiac allograft rejection (gene expression profiling and cell free DNA) have yet to be broadly integrated into heart transplant management and have shown limited discrimination (AUCs of 0.68 and 0.77, respectively). Changes in the electrocardiogram (ECG) have been reported at the time of severe cardiac rejection, including low voltages and conduction abnormalities. It remains unknown if subtle ECG changes correlating with cardiac allograft rejection can be detected earlier using machine learning methods. Purpose We sought to develop an artificial intelligence (AI) model to detect cardiac allograft rejection based on the 12 lead ECG. Methods We identified all patients who underwent a heart transplant at 3 hospital sites within a single health system from Jan 1998 through Apr 2021 and extracted digital 12-lead ECG data as well as endomyocardial biopsy pathology results from the electronic medical record. We partitioned our data into a training (80%), validation (10%), and test set (10%) based on a group stratification sampling. Each patient was present in only one set and each set had a positivity rate of 2.6% with 6,074/758/758 ECGs belonging to 1,146/140/141 unique patients in each set respectively. Cardiac allograft rejection was defined as moderate or severe acute cellular rejection based on International Society for Heart and Lung Transplantation (ISHLT) guidelines. A convolutional neural network, using the 12-lead ECG data as input, was trained with hyperparameter optimization for regularization, learning rate adjustments, and class weights. Model performance metrics were based on the test data and estimated using the final model architecture. Results 1,587 heart transplant recipients who had at least one endomyocardial biopsy were evaluated for inclusion. We limited our sample to ECGs performed within 30 days of the biopsy date (7,590 ECGs, representing 1,425 unique patients). Our study population had a median age of 55.8 years and 28.7% were female. The median number of ECG-biopsy pairs per patient was 5. The majority of endomyocardial biopsy results were classified as none or mild rejection (97.1%), and 2.9% had moderate/severe rejection. The ECG-based AI model detected cardiac allograft rejection with an area under the receiver operative curve (AUC) of 0.84 in the test set. The sensitivity, specificity, positive and negative predictive values were 95%, 52.6%. 5.2% and 99.7% respectively. Conclusions An AI-ECG model appears to outperform novel non-invasive laboratory tests (gene expression profiling and cell free DNA) for detecting cardiac allograft rejection and does not require a blood draw or the additional complexities surrounding sample processing. This model relies on a readily available and relatively inexpensive test, the ECG. In addition, AI predictions can be made available within a few minutes following ECG acquisition. Funding Acknowledgement Type of funding sources: Private hospital(s). Main funding source(s): Mayo Clinic