医学
大脑中动脉
神经组阅片室
基底动脉
放射科
闭塞
颈内动脉
急诊分诊台
人口统计学的
血管造影
计算机断层血管造影
椎动脉
冲程(发动机)
大脑前动脉
算法
神经学
外科
内科学
缺血
计算机科学
医疗急救
人口学
社会学
工程类
精神科
机械工程
作者
Mara Kunst,Rajiv Gupta,Laura P. Coombs,Jana G. Delfino,Amir Khan,Inka Berglar,None Dipl.-Math,Benjamin Kozak,Juan E. Small,Laura Gillis,Patrick Noonan,Junyong Fang,Vinay Pai,Mike Tilkin,Bibb Allen,Keith Dreyer,Christoph Wald
标识
DOI:10.1016/j.jacr.2023.04.003
摘要
To evaluate the real-world performance of two FDA-approved artificial intelligence (AI)-based computer-aided triage and notification (CADt) detection devices and compare them with the manufacturer-reported performance testing in the instructions for use.Clinical performance of two FDA-cleared CADt large-vessel occlusion (LVO) devices was retrospectively evaluated at two separate stroke centers. Consecutive "code stroke" CT angiography examinations were included and assessed for patient demographics, scanner manufacturer, presence or absence of CADt result, CADt result, and LVO in the internal carotid artery (ICA), horizontal middle cerebral artery (MCA) segment (M1), Sylvian MCA segments after the bifurcation (M2), precommunicating part of cerebral artery, postcommunicating part of the cerebral artery, vertebral artery, basilar artery vessel segments. The original radiology report served as the reference standard, and a study radiologist extracted the above data elements from the imaging examination and radiology report.At hospital A, the CADt algorithm manufacturer reports assessment of intracranial ICA and MCA with sensitivity of 97% and specificity of 95.6%. Real-world performance of 704 cases included 79 in which no CADt result was available. Sensitivity and specificity in ICA and M1 segments were 85.3% and 91.9%. Sensitivity decreased to 68.5% when M2 segments were included and to 59.9% when all proximal vessel segments were included. At hospital B the CADt algorithm manufacturer reports sensitivity of 87.8% and specificity of 89.6%, without specifying the vessel segments. Real-world performance of 642 cases included 20 cases in which no CADt result was available. Sensitivity and specificity in ICA and M1 segments were 90.7% and 97.9%. Sensitivity decreased to 76.4% when M2 segments were included and to 59.4% when all proximal vessel segments are included.Real-world testing of two CADt LVO detection algorithms identified gaps in the detection and communication of potentially treatable LVOs when considering vessels beyond the intracranial ICA and M1 segments and in cases with absent and uninterpretable data.
科研通智能强力驱动
Strongly Powered by AbleSci AI