Neural network analysis of serial cardiac enzyme data. A clinical application of artificial machine intelligence

There has been a recent resurgence of interest in the study and application of computerized neural networks within the broad field of artificial intelligence. These "intelligent machines" are modeled after biological nervous systems and are fundamentally different from the many computerized expert systems that previously have been introduced as clinical decision-making aids. The authors describe a neural network designed and trained to predict the probability of acute myocardial infarction (AMI) based on the analysis of paired sets of cardiac enzymes. The neural network predicted 24 of 24 (100%) AMIs and 27 of 29 (93%) No-AMIs when compared with a pathologist's interpretation of the patient's laboratory data (P less than 0.000001). The authors attempted to validate the network's diagnoses by two independent methods. When compared with echocardiogram and EKG for diagnosis of AMI, the neural network agreed with the cardiologist's interpretation in 12 of 14 (86%) AMIs and 1 of 3 (33%) No-AMIs, but the correlation was not statistically significant. Using autopsy outcome for validation, the neural network agreed with the anatomic evidence in 24 of 26 (92%) AMIs and 4 of 6 (67%) No-AMIs (P = 0.001). The authors conclude that neural networks can be successfully applied to the analysis of cardiac enzyme data and suggest that broader applications exist within the domain of clinical decision support.