Artificial Intelligence Applied to Cardiomyopathies: Is It Time for Clinical Application?

PURPOSE OF REVIEW: Artificial intelligence (AI) techniques have the potential to remarkably change the practice of cardiology in order to improve and optimize outcomes in heart failure and specifically cardiomyopathies, offering us novel tools to interpret data and make clinical decisions. The aim of this review is to describe the contemporary state of AI and digital health applied to cardiomyopathies as well as to define a potential pivotal role of its application by physicians in clinical practice. RECENT FINDINGS: Many studies have been undertaken in recent years on cardiomyopathy screening especially using AI-enhanced electrocardiography (ECG). Even with mild left ventricular (LV) dysfunction, AI-ECG screening for amyloidosis, hypertrophic cardiomyopathy, or dilated cardiomyopathy is now feasible. Introduction of AI-ECG in routine clinical care has resulted in higher detection of LV systolic dysfunction; however, clinical research on a broader scale with diverse populations is necessary and ongoing. In the area of cardiac-imaging, AI automatically assesses the thickness and characteristics of myocardium to differentiate cardiomyopathies, but research on its prognostic capability has yet to be conducted. AI is also being applied to cardiomyopathy genomics, especially to predict pathogenicity of variants and identify whether these variants are clinically actionable. While the implementation of AI in the diagnosis and treatment of cardiomyopathies is still in its infancy, an ever-growing clinical research strategy will ascertain the clinical utility of these AI tools to help improve diagnosis of and outcomes in cardiomyopathies. We also need to standardize the tools used to monitor the performance of AI-based systems which can then be used to expedite decision-making and rectify any hidden biases. Given its potential important role in clinical practice, healthcare providers need to familiarize themselves with the promise and limitations of this technology.

A Technical Performance Study and Proposed Systematic and Comprehensive Evaluation of an ML-based CDS Solution for Pediatric Asthma.

Achieving optimal care for pediatric asthma patients depends on giving clinicians efficient access to pertinent patient information. Unfortunately, adherence to guidelines or best practices has shown to be challenging, as relevant information is often scattered throughout the patient record in both structured data and unstructured clinical notes. Furthermore, in the absence of supporting tools, the onus of consolidating this information generally falls upon the clinician. In this study, we propose a machine learning-based clinical decision support (CDS) system focused on pediatric asthma care to alleviate some of this burden. This framework aims to incorporate a machine learning model capable of predicting asthma exacerbation risk into the clinical workflow, emphasizing contextual data, supporting information, and model transparency and explainability. We show that this asthma exacerbation model is capable of predicting exacerbation with an 0.8 AUC-ROC. This model, paired with a comprehensive informatics-based process centered on clinical usability, emphasizes our focus on meeting the needs of the clinical practice with machine learning technology.