实施国家人工智能技术计划,研究心血管疾病和卫生系统的结果
Timothy A Fairbairn1,2, Liam Mullen3, Edward Nicol4,5
1Liverpool Centre for Cardiovascular Science, Liverpool Heart and Chest Hospital, Liverpool, UK. tfair@liverpool.ac.uk.
Nature medicine
|April 4, 2025
概括
人工智能 (AI) 在计算机断层扫描 (CT) 衍生的分量流量储备 (FFR-CT) 中安全地减少了胸痛患者的心脏测试. 这种人工智能工具改善了决策,但没有影响死亡率,有利于患者和医疗保健系统.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 医疗保健中的人工智能
背景情况:
- 冠状动脉疾病 (CAD) 是全球主要的死亡和发病原因.
- 冠状动脉计算机断层血管造影 (CCTA) 是症状性CAD的主要诊断工具.
- 目前的诊断途径风险增加下游心脏检测和相关成本.
研究的目的:
- 为了评估人工智能 (AI) 诊断工具,计算机断层扫描 (CT) 衍生的分量流量储备 (FFR-CT) 对心血管结果的影响.
- 评估FFR-CT在改善医生决策和减少不必要的心脏手术方面的安全性和有效性.
- 分析FFR-CT实施对患者途径和医疗保健系统资源利用的影响.
主要方法:
- 一项观察性队列研究包括在27家医院的全国人工智能实施计划中接受CCTA调查的患者.
- 数据包括接受CCTA的90,553名患者和接受FFR-CT分析的7,863名患者.
- 心血管结果,包括全因死亡率,心血管死亡率,侵入性冠状动脉血管图和非侵入性心脏检测,在各组之间进行了比较.
主要成果:
- 与单独使用CCTA相比,FFR-CT证明了安全性,所有原因死亡率 (3.2%与2.9%) 或心血管死亡率 (1.3%与1.1%) 没有显著差异.
- 实施FFR-CT导致侵袭性冠状动脉血管图 (16%vs14.9%) 和非侵袭性心脏检测 (189/1,000vs167/1,000患者) 的显著减少.
- 人工智能诊断工具被证明是有益的,简化了患者护理途径,减少了医疗保健系统的负担.
结论:
- 将AI驱动的FFR-CT整合到临床实践中是安全有效的,用于调查疑似CAD患者.
- FFR-CT提高了诊断准确度,导致不必要的心脏干预和测试的显著减少.
- 这种人工智能干预对患者管理和医疗保健经济都有很大的好处.
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