在怀疑急性冠状动脉综合征时,使用深度学习来进行心电图解释的医院前风险分层化
Jesse P A Demandt1, Thomas P Mast2, Konrad A J van Beek2
1Department of Cardiology, Catharina Hospital, Eindhoven, Netherlands jesse.demandt@catharinaziekenhuis.nl.
BMJ health & care informatics
|June 6, 2025
概括
使用卷积神经网络 (CNN) 的新人工智能 (AI) 模型在紧急医疗服务 (EMS) 中有望识别非ST升高急性冠状动脉综合征 (NSTE-ACS) 的低风险患者. 虽然人工智能改善了心电图的解释,但临床风险得分仍然优越,但可以通过人工智能集成来提高.
科学领域:
- 心脏病学 心脏病学
- 人工智能的人工智能
- 医学诊断 医学诊断 医学诊断
背景情况:
- 胸痛是一种常见的紧急医疗服务 (EMS) 呈现,通常被怀疑是非ST升高急性冠状动脉综合征 (NSTE-ACS).
- 仅使用医院前心电图来区分NSTE-ACS与非心脏病原因是具有挑战性的.
- 准确的风险分层对于适当的患者分拣至关重要,减少急诊室过度拥挤和医疗保健成本.
研究的目的:
- 开发和验证基于CNN的模型 (ECG-AI) 用于NSTE-ACS在医院前环境中的风险分层.
- 将ECG-AI的诊断性能与现有的医院前工具进行比较.
- 评估将AI整合到临床风险得分中的潜力,以提高诊断准确度.
主要方法:
- 一个CNN模型 (ECG-AI) 被训练并验证在内部和外部队列的疑似NSTE-ACS患者.
- 在ECG-AI,护理人员ECG解读 (ECG-EMS),临床护理点素和preHEART临床风险评分之间进行了诊断性能比较.
- 该研究包括5645名涉嫌NSTE-ACS的患者,外部验证队列为754名患者.
主要成果:
- 与护理人员ECG解释相比,ECG-AI显示了NSTE-ACS的优越诊断性能 (AUROC 0.70与0.65).
- 在preHEART临床风险得分显示,诊断准确度 (AUROC 0.78) 比单独ECG-AI更高.
- 将ECG-AI集成到preHEART得分中显著改善了诊断性能 (AUROC 0.83).
结论:
- 人工智能在医院前心电图解释中的整合有助于识别低风险的NSTE-ACS患者.
- 目前的临床风险得分提供了最佳的诊断性能,但可以通过AI进一步改进.
- 这些发现支持进一步研究AI在急性冠状动脉综合征的医院前风险分层中的作用.
相关概念视频
01:29Electrocardiogram
2.2K
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
2.2K
01:28Electrocardiogram Fundamentals
549
Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
549
01:30Pulse rhythm
775
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
775