A formal validation of a deep learning-based automated workflow for the interpretation of the echocardiogram

This study compares a deep learning interpretation of 23 echocardiographic parameters-including cardiac volumes, ejection fraction, and Doppler measurements-with three repeated measurements by core lab sonographers. The primary outcome metric, the individual equivalence coefficient (IEC), compares the disagreement between deep learning and human readers relative to the disagreement among human readers. The pre-determined non-inferiority criterion is 0.25 for the upper bound of the 95% confidence interval. Among 602 anonymised echocardiographic studies from 600 people (421 with heart failure, 179 controls, 69% women), the point estimates of IEC are all <0 and the upper bound of the 95% confidence intervals below 0.25, indicating that the disagreement between the deep learning and human measures is lower than the disagreement among three core lab readers. These results highlight the potential of deep learning algorithms to improve efficiency and reduce the costs of echocardiography.