论文标题
通过使用人工智能和视网膜成像，替换基于弗雷明厄姆的方程来预测心血管疾病风险和不利结果
Replacing the Framingham-based equation for prediction of cardiovascular disease risk and adverse outcome by using artificial intelligence and retinal imaging
论文作者
论文摘要
目的：创建和评估人工智能深度学习平台（Oraicle）的准确性，能够仅使用视网膜眼镜图像来预测个人总体5年心血管风险（CVD）的个人，以及构成该风险的组件风险因素的相对贡献。方法：我们从47,236个患者就诊的数据库中使用了165,907个视网膜图像。最初，每个图像与生物识别数据年龄，种族，性别，性，存在和持续时间HDL/LDL比以及任何CVD事件Wtihin 5年的视网膜图像采集5年。计算了基于Framingham方程的风险评分。还确定了个人和整体人口的实际CVD事件率。最后，仅使用年龄，种族，性行为以及视网膜图像训练Oraicle。结果：与基于弗雷明厄姆的分数相比，在接下来的5年中，Oraicle在预测心血管事件方面的准确性高达12％，尤其是对于最高风险的人群。每个限制性模型的可靠性和准确性对Oraicle的性能均优于最佳性能，表明它使用了两组数据的数据来得出其最终结果。结论：视网膜摄影是便宜的，只需要最少的培训才能获得全自动，廉价的摄像头系统，现在可以广泛使用。因此，基于AI的CVD风险算法（例如Oraicle）有望使CV健康筛查更加准确，更加相处，并且更容易访问。此外，Oraicle评估构成个人总体风险的组件相对贡献的独特能力将根据个人的特定需求为治疗决策提供信息，从而增加了阳性健康结果的可能性。
Purpose: To create and evaluate the accuracy of an artificial intelligence Deep learning platform (ORAiCLE) capable of using only retinal fundus images to predict both an individuals overall 5 year cardiovascular risk (CVD) and the relative contribution of the component risk factors that comprise this risk. Methods: We used 165,907 retinal images from a database of 47,236 patient visits. Initially, each image was paired with biometric data age, ethnicity, sex, presence and duration of diabetes a HDL/LDL ratios as well as any CVD event wtihin 5 years of the retinal image acquisition. A risk score based on Framingham equations was calculated. The real CVD event rate was also determined for the individuals and overall population. Finally, ORAiCLE was trained using only age, ethnicity, sex plus retinal images. Results: Compared to Framingham-based score, ORAiCLE was up to 12% more accurate in prediciting cardiovascular event in he next 5-years, especially for the highest risk group of people. The reliability and accuracy of each of the restrictive models was suboptimal to ORAiCLE performance ,indicating that it was using data from both sets of data to derive its final results. Conclusion: Retinal photography is inexpensive and only minimal training is required to acquire them as fully automated, inexpensive camera systems are now widely available. As such, AI-based CVD risk algorithms such as ORAiCLE promise to make CV health screening more accurate, more afforadable and more accessible for all. Furthermore, ORAiCLE unique ability to assess the relative contribution of the components that comprise an individuals overall risk would inform treatment decisions based on the specific needs of an individual, thereby increasing the likelihood of positive health outcomes.
