Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 12;14(1):13503.
doi: 10.1038/s41598-024-62467-4.

Point-of-care AI-enhanced novice echocardiography for screening heart failure (PANES-HF)

Weiting Huang  1   2 , Tracy Koh  3   4 , Jasper Tromp  4   5 , Chanchal Chandramouli  3   4 , See Hooi Ewe  3   4 , Choon Ta Ng  3   4 , Audry Shan Yin Lee  3   4 , Louis Loon Yee Teo  3   4 , Yoran Hummel  6 , Feiqiong Huang  6 , Carolyn Su Ping Lam  3   4   6
Affiliations

Point-of-care AI-enhanced novice echocardiography for screening heart failure (PANES-HF)

Weiting Huang et al. Sci Rep. .

Abstract

The increasing prevalence of heart failure (HF) in ageing populations drives demand for echocardiography (echo). There is a worldwide shortage of trained sonographers and long waiting times for expert echo. We hypothesised that artificial intelligence (AI)-enhanced point-of-care echo can enable HF screening by novices. The primary endpoint was the accuracy of AI-enhanced novice pathway in detecting reduced LV ejection fraction (LVEF) < 50%. Symptomatic patients with suspected HF (N = 100, mean age 61 ± 15 years, 56% men) were prospectively recruited. Novices with no prior echo experience underwent 2-weeks' training to acquire echo images with AI guidance using the EchoNous Kosmos handheld echo, with AI-automated reporting by Us2.ai (AI-enhanced novice pathway). All patients also had standard echo by trained sonographers interpreted by cardiologists (reference standard). LVEF < 50% by reference standard was present in 27 patients. AI-enhanced novice pathway yielded interpretable results in 96 patients and took a mean of 12 min 51 s per study. The area under the curve (AUC) of the AI novice pathway was 0.880 (95% CI 0.802, 0.958). The sensitivity, specificity, positive predictive and negative predictive values of the AI-enhanced novice pathway in detecting LVEF < 50% were 84.6%, 91.4%, 78.5% and 94.1% respectively. The median absolute deviation of the AI-novice pathway LVEF from the reference standard LVEF was 6.03%. AI-enhanced novice pathway holds potential to task shift echo beyond tertiary centres and improve the HF diagnostic workflow.

Keywords: Artificial intelligence; Heart failure diagnostic pathway; Heart failure screening; Novice ultrasound.

PubMed Disclaimer

Conflict of interest statement

JT is supported by the National University of Singapore Start-up grant, the tier 1 grant from the ministry of education and the CS-IRG New Investigator Grant from the National Medical Research Council; has received consulting or speaker fees from Daiichi-Sankyo, Boehringer Ingelheim, Roche diagnostics and Us2.ai, co-owns patent US-10702247-B2. CC reports philanthropic research grants from Lee Foundation Singapore and consulting/speaker fees from Boehringer Ingelheim, Sanofi Aventis and Us2.ai. YMH and FH are employees of Us2.ai. CSPL is supported by a Clinician Scientist Award from the National Medical Research Council of Singapore; has received research support from NovoNordisk and Roche Diagnostics; has served as consultant or on the Advisory Board/ Steering Committee/ Executive Committee for Alleviant Medical, Allysta Pharma, Amgen, AnaCardio AB, Applied Therapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Cytokinetics, Darma Inc., EchoNous Inc, Eli Lilly, Impulse Dynamics, Intellia Therapeutics, Ionis Pharmaceutical, Janssen Research & Development LLC, Medscape/WebMD Global LLC, Merck, Novartis, Novo Nordisk, Prosciento Inc, Radcliffe Group Ltd., Recardio Inc, ReCor Medical, Roche Diagnostics, Sanofi, Siemens Healthcare Diagnostics and Us2.ai; and serves as co-founder & non-executive director of Us2.ai. All other authors declare no competing interests.

Figures

Figure 1
Figure 1
Absolute difference between reference standard and AI-enhanced novice pathway LVEF.
Figure 2
Figure 2
Learning curve by cumulative average of scan durations.
See this image and copyright information in PMC

References

    1. van Riet EES, et al. Epidemiology of heart failure: The prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review. Eur. J. Heart Fail. 2016;18:242–252. doi: 10.1002/ejhf.483. - DOI - PubMed
    1. Tromp J, et al. A systematic review and network meta-analysis of pharmacological treatment of heart failure with reduced ejection fraction. JACC Heart Fail. 2022;10:73–84. doi: 10.1016/j.jchf.2021.09.004. - DOI - PubMed
    1. Shen L, et al. Accelerated and personalized therapy for heart failure with reduced ejection fraction. Eur. Heart J. 2022;43:2573–2587. doi: 10.1093/eurheartj/ehac210. - DOI - PubMed
    1. Tromp J, Voors AA. Heart failure medication: Moving from evidence generation to implementation. Eur. Heart J. 2022;43:2588–2590. doi: 10.1093/eurheartj/ehac272. - DOI - PubMed
    1. Tsao CW, et al. Temporal trends in the incidence of and mortality associated with heart failure with preserved and reduced ejection fraction. JACC Heart Fail. 2018;6:678–685. doi: 10.1016/j.jchf.2018.03.006. - DOI - PMC - PubMed