Artificial intelligence-assisted auscultation in detecting congenital heart disease

Author:

Lv Jingjing12ORCID,Dong Bin3,Lei Hao4,Shi Guocheng1,Wang Hansong35,Zhu Fang1,Wen Chen1,Zhang Qian1,Fu Lijun1,Gu Xiaorong1,Yuan Jiajun1,Guan Yongmei1,Xia Yuxian1,Zhao Liebin35,Chen Huiwen13

Affiliation:

1. Department of Cardiothoracic Surgery, Heart Center, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, NO.1678 Dongfang Road, Pudong New District, Shanghai 200127, PR China

2. Department of Anesthesiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, NO.1678 Dongfang Road, Pudong New District, Shanghai 200127, PR China

3. Pediatric AI Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, NO.1678 Dongfang Road, Pudong New District, Shanghai 200127, PR China

4. Shanghai FitGreat Network Technology Co. Ltd, Room 402, Building 32, No. 680 Guiping Road, Xuhui District, Shanghai 200233, PR China

5. Child Health Advocacy Institute, China Hospital Development Institute of Shanghai Jiaotong University, NO.1678 Dongfang Road, Pudong New District, Shanghai 200127, PR China

Abstract

Abstract Aims Computer-assisted auscultation has become available to assist clinicians with physical examinations to detect congenital heart disease (CHD). However, its accuracy and effectiveness remain to be evaluated. This study seeks to evaluate the accuracy of auscultations of abnormal heart sounds of an artificial intelligence-assisted auscultation (AI-AA) platform we create. Methods and results Initially, 1397 patients with CHD were enrolled in the study. The samples of their heart sounds were recorded and uploaded to the platform using a digital stethoscope. By the platform, both remote auscultation by a team of experienced cardiologists from Shanghai Children’s Medical Center and automatic auscultation of the heart sound samples were conducted. Samples of 35 patients were deemed unsuitable for the analysis; therefore, the remaining samples from 1362 patients (mean age—2.4 ± 3.1 years and 46% female) were analysed. Sensitivity, specificity, and accuracy were calculated for remote auscultation compared to experts’ face-to-face auscultation and for artificial intelligence automatic auscultation compared to experts’ face-to-face auscultation. Kappa coefficients were measured. Compared to face-to-face auscultation, remote auscultation detected abnormal heart sound with 98% sensitivity, 91% specificity, 97% accuracy, and kappa coefficient 0.87. AI-AA demonstrated 97% sensitivity, 89% specificity, 96% accuracy, and kappa coefficient 0.84. Conclusions The remote auscultations and automatic auscultations, using the AI-AA platform, reported high auscultation accuracy in detecting abnormal heart sound and showed excellent concordance to experts’ face-to-face auscultation. Hence, the platform may provide a feasible way to screen and detect CHD.

Funder

Shanghai Science and Technology Committee

Shanghai Municipal Commission of Economy and Informatization

Shanghai Artificial Intelligence Pilot Application Scenario

National Natural Science Foundation of China

Shanghai Municipal Health Commission

Science and Technology Commission of Shanghai Municipality

Shanghai Jiaotong University School of Medicine

Publisher

Oxford University Press (OUP)

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