论文标题

使用人工智能检测胸部X射线,在芬兰Oulu的初级医疗保健环境中没有明显的发现

Using artificial intelligence to detect chest X-rays with no significant findings in a primary health care setting in Oulu, Finland

论文作者

Keski-Filppula, Tommi, Nikki, Marko, Haapea, Marianne, Ramanauskas, Naglis, Tervonen, Osmo

论文摘要

目标:评估基于人工智能的软件在排除胸部X射线案例中的使用,在初级医疗保健环境中没有明显的发现。 方法:在这项回顾性研究中,使用市售的人工智能(AI)软件来分析芬兰初级卫生保健患者的10 000胸X射线。在AI正常报告与原始放射科医生报告之间的不匹配研究中,进行了两名经过董事会认证的放射科医生的共识,以进行最终诊断。 结果:排除案件不符合研究标准后,通过AI分析了9579例案件。在这些情况下,在原始放射科医生报告中认为4451是正常的,在共识阅读后4644中被认为是正常的。 AI正确发现的案例数为1692年(所有研究的17.7%,没有显着发现的研究中有36.4%)。共识阅读后,有9项已确认的假阴性研究。这些研究包括四例心脏大小略有扩大的病例,四例肺部粘附略有增加的病例和一个单侧胸腔积液少的病例。这使AI的灵敏度为99.8%(95%CI = 99.65-99.92),特异性为36.4%(95%CI = 35.05-37.84),用于识别胸部X射线上的重要病理。 结论:AI能够正确排除36.4%的胸部X射线检查,没有明显的初级卫生保健患者的显着发现,其虚假负面因素数量最少,这将导致对患者安全的有效损害。该软件没有错过任何关键发现。

Objectives: To assess the use of artificial intelligence-based software in ruling out chest X-ray cases, with no significant findings in a primary health care setting. Methods: In this retrospective study, a commercially available artificial intelligence (AI) software was used to analyse 10 000 chest X-rays of Finnish primary health care patients. In studies with a mismatch between an AI normal report and the original radiologist report, a consensus read by two board-certified radiologists was conducted to make the final diagnosis. Results: After the exclusion of cases not meeting the study criteria, 9579 cases were analysed by AI. Of these cases, 4451 were considered normal in the original radiologist report and 4644 after the consensus reading. The number of cases correctly found nonsignificant by AI was 1692 (17.7% of all studies and 36.4% of studies with no significant findings). After the consensus read, there were nine confirmed false-negative studies. These studies included four cases of slightly enlarged heart size, four cases of slightly increased pulmonary opacification and one case with a small unilateral pleural effusion. This gives the AI a sensitivity of 99.8% (95% CI= 99.65-99.92) and specificity of 36.4 % (95% CI= 35.05-37.84) for recognising significant pathology on a chest X-ray. Conclusions: AI was able to correctly rule out 36.4% of chest X-rays with no significant findings of primary health care patients, with a minimal number of false negatives that would lead to effectively no compromise on patient safety. No critical findings were missed by the software.

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