BackgroundIn‐hospital cardiac arrest is a major burden to public health, which affects patient safety. Although traditional track‐and‐trigger systems are used to predict cardiac arrest early, they have limitations, with low sensitivity and high false‐alarm rates. We propose a deep learning–based early warning system that shows higher performance than the existing track‐and‐trigger systems.Methods and ResultsThis retrospective cohort study reviewed patients who were admitted to 2 hospitals from June 2010 to July 2017. A total of 52 131 patients were included. Specifically, a recurrent neural network was trained using data from June 2010 to January 2017. The result was tested using the data from February to July 2017. The primary outcome was cardiac arrest, and the secondary outcome was death without attempted resuscitation. As comparative measures, we used the area under the receiver operating characteristic curve (AUROC), the area under the precision–recall curve (AUPRC), and the net reclassification index. Furthermore, we evaluated sensitivity while varying the number of alarms. The deep learning–based early warning system (AUROC: 0.850; AUPRC: 0.044) significantly outperformed a modified early warning score (AUROC: 0.603; AUPRC: 0.003), a random forest algorithm (AUROC: 0.780; AUPRC: 0.014), and logistic regression (AUROC: 0.613; AUPRC: 0.007). Furthermore, the deep learning–based early warning system reduced the number of alarms by 82.2%, 13.5%, and 42.1% compared with the modified early warning system, random forest, and logistic regression, respectively, at the same sensitivity.ConclusionsAn algorithm based on deep learning had high sensitivity and a low false‐alarm rate for detection of patients with cardiac arrest in the multicenter study.
Objectives: As the performance of a conventional track and trigger system in a rapid response system has been unsatisfactory, we developed and implemented an artificial intelligence for predicting in-hospital cardiac arrest, denoted the deep learning-based early warning system. The purpose of this study was to compare the performance of an artificial intelligence-based early warning system with that of conventional methods in a real hospital situation. Design: Retrospective cohort study. Setting: This study was conducted at a hospital in which deep learning-based early warning system was implemented. Patients: We reviewed the records of adult patients who were admitted to the general ward of our hospital from April 2018 to March 2019. Interventions: The study population included 8,039 adult patients. A total 83 events of deterioration occurred during the study period. The outcome was events of deterioration, defined as cardiac arrest and unexpected ICU admission. We defined a true alarm as an alarm occurring within 0.5–24 hours before a deteriorating event. Measurements and Main Results: We used the area under the receiver operating characteristic curve, area under the precision-recall curve, number needed to examine, and mean alarm count per day as comparative measures. The deep learning-based early warning system (area under the receiver operating characteristic curve, 0.865; area under the precision-recall curve, 0.066) outperformed the modified early warning score (area under the receiver operating characteristic curve, 0.682; area under the precision-recall curve, 0.010) and reduced the number needed to examine and mean alarm count per day by 69.2% and 59.6%, respectively. At the same specificity, deep learning-based early warning system had up to 257% higher sensitivity than conventional methods. Conclusions: The developed artificial intelligence based on deep-learning, deep learning-based early warning system, accurately predicted deterioration of patients in a general ward and outperformed conventional methods. This study showed the potential and effectiveness of artificial intelligence in an rapid response system, which can be applied together with electronic health records. This will be a useful method to identify patients with deterioration and help with precise decision-making in daily practice.
Aims Although left ventricular hypertrophy (LVH) has a high incidence and clinical importance, the conventional diagnosis criteria for detecting LVH using electrocardiography (ECG) has not been satisfied. We aimed to develop an artificial intelligence (AI) algorithm for detecting LVH. Methods and results This retrospective cohort study involved the review of 21 286 patients who were admitted to two hospitals between October 2016 and July 2018 and underwent 12-lead ECG and echocardiography within 4 weeks. The patients in one hospital were divided into a derivation and internal validation dataset, while the patients in the other hospital were included in only an external validation dataset. An AI algorithm based on an ensemble neural network (ENN) combining convolutional and deep neural network was developed using the derivation dataset. And we visualized the ECG area that the AI algorithm used to make the decision. The area under the receiver operating characteristic curve of the AI algorithm based on ENN was 0.880 (95% confidence interval 0.877–0.883) and 0.868 (0.865–0.871) during the internal and external validations. These results significantly outperformed the cardiologist’s clinical assessment with Romhilt-Estes point system and Cornell voltage criteria, Sokolov-Lyon criteria, and interpretation of ECG machine. At the same specificity, the AI algorithm based on ENN achieved 159.9%, 177.7%, and 143.8% higher sensitivities than those of the cardiologist’s assessment, Sokolov-Lyon criteria, and interpretation of ECG machine. Conclusion An AI algorithm based on ENN was highly able to detect LVH and outperformed cardiologists, conventional methods, and other machine learning techniques.
AimTriage is important in identifying high-risk patients amongst many less urgent patients as emergency department (ED) overcrowding has become a national crisis recently. This study aims to validate that a Deep-learning-based Triage and Acuity Score (DTAS) identifies high-risk patients more accurately than existing triage and acuity scores using a large national dataset.MethodsWe conducted a retrospective observational cohort study using data from the Korean National Emergency Department Information System (NEDIS), which collected data on visits in real time from 151 EDs. The NEDIS data was split into derivation data (January 2014-June 2016) and validation data (July-December 2016). We also used data from the Sejong General Hospital (SGH) for external validation (January-December 2017). We predicted in-hospital mortality, critical care, and hospitalization using initial information of ED patients (age, sex, chief complaint, time from symptom onset to ED visit, arrival mode, trauma, initial vital signs and mental status as predictor variables).ResultsA total of 11,656,559 patients were included in this study. The primary outcome was in-hospital mortality. The Area Under the Receiver Operating Characteristic curve (AUROC) and Area Under the Precision and Recall Curve (AUPRC) of DTAS were 0.935 and 0.264. It significantly outperformed Korean triage and acuity score (AUROC:0.785, AUPRC:0.192), modified early warning score (AUROC:0.810, AUPRC:0.116), logistic regression (AUROC:0.903, AUPRC:0.209), and random forest (AUROC:0.910, AUPRC:0.179).ConclusionDeep-learning-based Triage and Acuity Score predicted in-hospital mortality, critical care, and hospitalization more accurately than existing triages and acuity, and it was validated using a large, multicenter dataset.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.