Diagnostic accuracy of point-of-care ultrasound with artificial intelligence-assisted assessment of left ventricular ejection fraction.

Autor: Motazedian P; CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada., Marbach JA; Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Sciences University, Portland, OR, USA., Prosperi-Porta G; CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada., Parlow S; CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada., Di Santo P; CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada., Abdel-Razek O; CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada., Jung R; CAPITAL Research Group, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada., Bradford WB; Division of Cardiology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA., Tsang M; Division of Cardiology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA., Hyon M; Division of Cardiology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA., Pacifici S; Division of Cardiology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA., Mohanty S; Division of Cardiology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA., Ramirez FD; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada., Huggins GS; Division of Cardiology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA., Simard T; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA., Hon S; Division of Pulmonary and Critical Care Medicine, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA., Hibbert B; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA. Hibbert.Benjamin@mayo.edu.
Jazyk: angličtina
Zdroj: NPJ digital medicine [NPJ Digit Med] 2023 Oct 28; Vol. 6 (1), pp. 201. Date of Electronic Publication: 2023 Oct 28.
DOI: 10.1038/s41746-023-00945-1
Abstrakt: 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.
(© 2023. The Author(s).)
Databáze: MEDLINE
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