What You Should Know:
– In a first-of-its-kind randomized clinical trial led by researchers at the Smidt Heart Institute and the Division of Artificial Intelligence in Medicine at Cedars-Sinai, artificial intelligence (AI) proved more successful in assessing and diagnosing cardiac function when compared to echocardiogram assessments made by sonographers.
– The results, announced during a late-breaking presentation at the European Society of Cardiology Congress 2022, have immediate translational implications for patients undergoing cardiac function imaging and broader implications for the field of cardiac imaging.
AI-Driven Diagnostic Models
Diagnosing cardiac pathologies from echocardiograms correctly can be an extremely challenging endeavor that only very skilled cardiologists can perform with ease. This latest breakthrough contains the potential to completely shift the narrative when it comes to diagnostic medicine, and can ultimately save countless lives in the near future.
Previously, researchers at the Smidt Heart Institute and Stanford University developed one of the first artificial intelligence technologies to assess cardiac function, specifically, left ventricular ejection fraction—the key heart measurement used in diagnosing cardiac function. Their research was published in the prestigious journal Nature.
Building on this past research, the most recent study assessed the impact of artificial intelligence in clinical deployment as part of a prospective, blinded and randomized controlled clinical trial.
In the study, Cedars-Sinai cardiologists evaluated 3,495 transthoracic echocardiogram studies, comparing initial assessment by artificial intelligence or by a sonographer—also known as an ultrasound technician.
One of the major findings was that cardiologists more frequently agreed with the AI initial assessment, such that they corrected only 16.8% of the initial assessments made by AI and simultaneously corrected 27.2% of the initial assessments made by the sonographers. This difference demonstrated not only non-inferiority but actually the superiority of AI.
The research team also discovered that cardiologists were unable to distinguish between initial assessments made by the AI and sonographers.
“We asked our cardiologist over-readers to guess if they thought the tracing they had just reviewed was performed by AI or by a sonographer, and it turns out that they couldn’t tell the difference,” said Ouyang. “This speaks to the strong performance of the AI algorithm as well as the seamless integration into clinical software. We believe these are all good signs for future trial research in the field.”
Additionally, the Smidt Heart Institute research team learned that this type of clinical trial can be seamlessly integrated into the standard clinical workflow.
“We are excited by the implications of this clinical trial and what it means for the future of artificial intelligence and cardiology,” said Susan Cheng, MD, MPH, director of the Institute for Research on Healthy Aging in the Department of Cardiology at the Smidt Heart Institute and EchoNet-RCT investigator. “When developed in the right way, artificial intelligence offers the opportunity to improve the quality of echocardiogram readings as well as increase efficiencies in the time and effort spent by busy cardiologists and sonographers alike.”
As a next step, Ouyang says the Smidt Heart Institute team plans to evaluate how AI analysis applied to Cedars-Sinai echocardiogram imaging procedures may improve clinical outcomes.