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  5. Automated left ventricular dimension assessment using artificial intelligence developed and validated by a UK-wide collaborative
 
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Automated left ventricular dimension assessment using artificial intelligence developed and validated by a UK-wide collaborative
File(s)
CIRCIMAGING.120.011951.pdf (909.91 KB)
Published version
Author(s)
Howard, James
Stowell, Cahterine
Cole, Graham
Ananthan, Kajaluxy
Camelia, Demetrescu
more
Type
Journal Article
Abstract
Background: Echocardiography artificial intelligence (AI) requires training and validation to standards expected of humans. We developed an online platform and established the Unity Collaborative to build a dataset of expertise from 17 hospitals for training, validation, and standardisation of such techniques. Methods: The training dataset were 2056individual frames drawn at random from 1265parasternal long-axis video-loops of patients undergoing clinical echocardiography in 2015-2016. Nine experts labelled these images using our online platform. From this, we trained a convolutional neural network to identify key points. Subsequently, 13 experts labelled a validation dataset of the end-systolic and end-diastolic frame from100new video-loops, twice each. The 26-opinionconsensus was used as the reference standard. The primary outcome was “precision SD”, the standard deviation of difference between AI measurement and expert consensus. Results: In the validation dataset, the AI’s precision SD for left ventricular internal dimension was 3.5mm. For context, precision SD of individual expert measurements against the expert consensus was 4.4mm. Intraclass correlation coefficient (ICC) between AI and expert consensus was 0.926 (95% CI 0.904–0.944), compared with 0.817 (0.778–0.954) between individual experts and expert consensus. For interventricular septum thickness, precision SD was 1.8mm for AI (ICC 0.809; 0.729–0.967), versus 2.0 for individuals (ICC 0.641; 0.568–0.716). For posterior wall thickness, precision SD was 1.4mm for AI (ICC 0.535; 95% CI 0.379–0.661), versus 2.2mm for individuals(0.366; 0.288 to 0.462).We present all images and annotations. This highlights challenging cases, including poor image quality, tapered ventricles, and indistinct boundaries. Conclusions: Experts at multiple institutions successfully cooperated to build a collaborative AI. This performed as well as individual experts. Future echocardiographic AI research should use a consensus of experts as a reference. Our collaborative welcomes new partners who share our commitment to publish all methods, code, annotations and results openly.
Date Issued
2021-05-17
Date Acceptance
2021-02-24
Citation
Circulation: Cardiovascular Imaging, 2021, 14 (5), pp.405-415
URI
http://hdl.handle.net/10044/1/88288
URL
https://www.ahajournals.org/doi/10.1161/CIRCIMAGING.120.011951
DOI
https://www.dx.doi.org/10.1161/CIRCIMAGING.120.011951
ISSN
1941-9651
Publisher
American Heart Association
Start Page
405
End Page
415
Journal / Book Title
Circulation: Cardiovascular Imaging
Volume
14
Issue
5
Copyright Statement
© 2021 The Authors. Circulation:
Cardiovascular Imaging is published
on behalf of the American Heart
Association, Inc., by Wolters Kluwer
Health, Inc. This is an open access
article under the terms of the Creative
Commons Attribution License,
which permits use, distribution, and
reproduction in any medium, provided
that the original work is properly cited.
License URL
https://creativecommons.org/licenses/by/4.0/
Sponsor
Wellcome Trust
British Heart Foundation
Identifier
https://www.ahajournals.org/doi/10.1161/CIRCIMAGING.120.011951
Grant Number
PS3162_WHCP
PG/19/78/34733
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Radiology, Nuclear Medicine & Medical Imaging
Cardiovascular System & Cardiology
consensus
echocardiography
hospital
left ventricle
machine learning
EUROPEAN ASSOCIATION
ECHOCARDIOGRAPHY
consensus
echocardiography
hospital
left ventricle
machine learning
1103 Clinical Sciences
Cardiovascular System & Hematology
Publication Status
Published
Date Publish Online
2021-05-17
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