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Artificial intelligence in cardiovascular medicine

#artificialintelligence

Artificial intelligence (AI) is a rapidly evolving transdisciplinary field employing machine learning (ML) techniques, which aim to simulate human intuition to offer cost-effective and scalable solutions to better manage CVD. ML algorithms are increasingly being developed and applied in various facets of cardiovascular medicine, including and not limited to heart failure, electrophysiology, valvular heart disease and coronary artery disease. Within heart failure, AI algorithms can augment diagnostic capabilities and clinical decision-making through automated cardiac measurements. Occult cardiac disease is increasingly being identified using ML from diagnostic data. Improved diagnostic and prognostic capabilities using ML algorithms are enhancing clinical care of patients with valvular heart disease and coronary artery disease. The growth of AI techniques is not without inherent challenges, most important of which is the need for greater external validation through multicenter, prospective clinical trials.


Life-threatening ventricular arrhythmia prediction in patients with dilated cardiomyopathy using explainable electrocardiogram-based deep neural networks

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The study population were patients with dilated cardiomyopathy, in which an explainable pre-trained deep neural network (FactorECG) was trained for the outcome of life-threatening ventricular arrhythmias. This network encoded the median beat ECG into 21 factors to generate an ECG using only these factors, allowing to evaluate most characteristics that make up an ECG automatically, in a relatively small dataset. LVAD, left ventricular assist device.


Mental Stress Detection using Data from Wearable and Non-wearable Sensors: A Review

arXiv.org Artificial Intelligence

This paper presents a comprehensive review of methods covering significant subjective and objective human stress detection techniques available in the literature. The methods for measuring human stress responses could include subjective questionnaires (developed by psychologists) and objective markers observed using data from wearable and non-wearable sensors. In particular, wearable sensor-based methods commonly use data from electroencephalography, electrocardiogram, galvanic skin response, electromyography, electrodermal activity, heart rate, heart rate variability, and photoplethysmography both individually and in multimodal fusion strategies. Whereas, methods based on non-wearable sensors include strategies such as analyzing pupil dilation and speech, smartphone data, eye movement, body posture, and thermal imaging. Whenever a stressful situation is encountered by an individual, physiological, physical, or behavioral changes are induced which help in coping with the challenge at hand. A wide range of studies has attempted to establish a relationship between these stressful situations and the response of human beings by using different kinds of psychological, physiological, physical, and behavioral measures. Inspired by the lack of availability of a definitive verdict about the relationship of human stress with these different kinds of markers, a detailed survey about human stress detection methods is conducted in this paper. In particular, we explore how stress detection methods can benefit from artificial intelligence utilizing relevant data from various sources. This review will prove to be a reference document that would provide guidelines for future research enabling effective detection of human stress conditions.


AI In Healthcare Highlights & Milestones 2021

#artificialintelligence

In 2021 the application of AI enabled advances in many areas of healthcare. We made significant progress in AI for drug discovery, medical imaging, diagnostics, pathology, and clinical trials. Important peer reviewed papers were published and dozens of partnerships were formed. Big Pharma companies and major tech companies became very active in the space. Record amounts of funding were raised, and a few companies even started human clinical trials. Microsoft and NVIDIA launched two of the world's most powerful supercomputers and Microsoft announced Azure OpenAI Service. In 2022 we expect these technologies to converge across the healthcare spectrum. This article summarizes milestones achieved in 2021. This is the first in a series of progress reports I'm writing on the sector that will be supplemented by industry performance data and metrics compiled in partnership with Alliance for Artificial Intelligence in Healthcare (AAIH) and other top tier resources.


Use of machine learning in geriatric clinical care for chronic diseases: a systematic literature review

arXiv.org Artificial Intelligence

Objectives-Geriatric clinical care is a multidisciplinary assessment designed to evaluate older patients (age 65 years and above) functional ability, physical health, and cognitive wellbeing. The majority of these patients suffer from multiple chronic conditions and require special attention. Recently, hospitals utilize various artificial intelligence (AI) systems to improve care for elderly patients. The purpose of this systematic literature review is to understand the current use of AI systems, particularly machine learning (ML), in geriatric clinical care for chronic diseases. Materials and Methods-We restricted our search to eight databases, namely PubMed, WorldCat, MEDLINE, ProQuest, ScienceDirect, SpringerLink, Wiley, and ERIC, to analyze research articles published in English between January 2010 and June 2019. We focused on studies that used ML algorithms in the care of geriatrics patients with chronic conditions. Results-We identified 35 eligible studies and classified in three groups-psychological disorder (n=22), eye diseases (n=6), and others (n=7). This review identified the lack of standardized ML evaluation metrics and the need for data governance specific to health care applications. Conclusion- More studies and ML standardization tailored to health care applications are required to confirm whether ML could aid in improving geriatric clinical care.


Improving the efficacy of Deep Learning models for Heart Beat detection on heterogeneous datasets

arXiv.org Machine Learning

Deep Learning (DL) have greatly contributed to bioelectric signals processing, in particular to extract physiological markers. However, the efficacy and applicability of the results proposed in the literature is often constrained to the population represented by the data used to train the models. In this study, we investigate the issues related to applying a DL model on heterogeneous datasets. In particular, by focusing on heart beat detection from Electrocardiogram signals (ECG), we show that the performance of a model trained on data from healthy subjects decreases when applied to patients with cardiac conditions and to signals collected with different devices. We then evaluate the use of Transfer Learning (TL) to adapt the model to the different datasets. In particular, we show that the classification performance is improved, even with datasets with a small sample size. These results suggest that a greater effort should be made towards generalizability of DL models applied on bioelectric signals, in particular by retrieving more representative datasets.


ECG-AI: electrocardiographic artificial intelligence model for prediction of heart failure

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Heart failure (HF) is a leading cause of death. Early intervention is the key to reduce HF-related morbidity and mortality. Data from the baseline visits (1987–89) of the Atherosclerosis Risk in Communities (ARIC) study was used. Incident hospitalized HF events were ascertained by ICD codes. Participants with good quality baseline ECGs were included. Participants with prevalent HF were excluded. ECG-artificial intelligence (AI) model to predict HF was created as a deep residual convolutional neural network (CNN) utilizing standard 12-lead ECG. The area under the receiver operating characteristic curve (AUC) was used to evaluate prediction models including (CNN), light gradient boosting machines (LGBM), and Cox proportional hazards regression. A total of 14 613 (45% male, 73% of white, mean age standard deviation of 54 5) participants were eligible.


Combining chest X-rays and EHR data using machine learning to diagnose acute respiratory failure

arXiv.org Artificial Intelligence

When patients develop acute respiratory failure, accurately identifying the underlying etiology is essential for determining the best treatment, but it can be challenging to differentiate between common diagnoses in clinical practice. Machine learning models could improve medical diagnosis by augmenting clinical decision making and play a role in the diagnostic evaluation of patients with acute respiratory failure. While machine learning models have been developed to identify common findings on chest radiographs (e.g. pneumonia), augmenting these approaches by also analyzing clinically relevant data from the electronic health record (EHR) could aid in the diagnosis of acute respiratory failure. Machine learning models were trained to predict the cause of acute respiratory failure (pneumonia, heart failure, and/or COPD) using chest radiographs and EHR data from patients within an internal cohort using diagnoses based on physician chart review. Models were also tested on patients in an external cohort using discharge diagnosis codes. A model combining chest radiographs and EHR data outperformed models based on each modality alone for pneumonia and COPD. For pneumonia, the combined model AUROC was 0.79 (0.78-0.79), image model AUROC was 0.73 (0.72-0.75), and EHR model AUROC was 0.73 (0.70-0.76); for COPD, combined: 0.89 (0.83-0.91), image: 0.85 (0.77-0.89), and EHR: 0.80 (0.76-0.84); for heart failure, combined: 0.80 (0.77-0.84), image: 0.77 (0.71-0.81), and EHR: 0.80 (0.75-0.82). In the external cohort, performance was consistent for heart failure and COPD, but declined slightly for pneumonia. Overall, machine learning models combing chest radiographs and EHR data can accurately differentiate between common causes of acute respiratory failure. Further work is needed to determine whether these models could aid clinicians in the diagnosis of acute respiratory failure in clinical settings.


VBridge: Connecting the Dots Between Features, Explanations, and Data for Healthcare Models

arXiv.org Artificial Intelligence

Machine learning (ML) is increasingly applied to Electronic Health Records (EHRs) to solve clinical prediction tasks. Although many ML models perform promisingly, issues with model transparency and interpretability limit their adoption in clinical practice. Directly using existing explainable ML techniques in clinical settings can be challenging. Through literature surveys and collaborations with six clinicians with an average of 17 years of clinical experience, we identified three key challenges, including clinicians' unfamiliarity with ML features, lack of contextual information, and the need for cohort-level evidence. Following an iterative design process, we further designed and developed VBridge, a visual analytics tool that seamlessly incorporates ML explanations into clinicians' decision-making workflow. The system includes a novel hierarchical display of contribution-based feature explanations and enriched interactions that connect the dots between ML features, explanations, and data. We demonstrated the effectiveness of VBridge through two case studies and expert interviews with four clinicians, showing that visually associating model explanations with patients' situational records can help clinicians better interpret and use model predictions when making clinician decisions. We further derived a list of design implications for developing future explainable ML tools to support clinical decision-making.


Deep learning with SPECT accurately predicts major adverse cardiac events

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An advanced artificial intelligence technique known as deep learning can predict major adverse cardiac events more accurately than current standard imaging protocols, according to research presented at the Society of Nuclear Medicine and Molecular Imaging 2021 Annual Meeting. Utilizing data from a registry of more than 20,000 patients, researchers developed a novel deep learning network that has the potential to provide patients with an individualized prediction of their annualized risk for adverse events such as heart attack or death. Deep learning is a subset of artificial intelligence that mimics the workings of the human brain to process data. Deep learning algorithms use multiple layers of "neurons," or non-linear processing units, to learn representations and identify latent features relevant to a specific task, making sense of multiple types of data. It can be used for tasks such as predicting cardiovascular disease and segmenting lungs, among others.