TECHNOLOGY IN ANESTHESIA

A commercial artificial intelligence (AI) tool used off-label was effective at excluding pathology and had equal or lower rates of critical misses on chest X-ray than radiologists, according to a study published in Radiology, a journal of the Radiological Society of North America (RSNA).

Recent developments in AI have sparked a growing interest in computer-assisted diagnosis, partly motivated by the increasing workload faced by radiology departments, the global shortage of radiologists and the potential for burnout in the field. Radiology practices have a high volume of unremarkable (no clinically significant findings) chest X-rays, and AI could possibly improve workflow by providing an automatic report.

Researchers in Denmark set out to estimate the proportion of unremarkable chest X-rays where AI could correctly exclude pathology without increasing diagnostic errors. The study included radiology reports and data from 1,961 patients (median age, 72 years; 993 female), with one chest X-ray per patient, obtained from four Danish hospitals.

The research team wanted to know whether the quality of mistakes made by AI and radiologists was different and if AI mistakes, on average, are objectively worse than human mistakes.

The AI tool was adapted to generate a chest X-ray “remarkableness” probability, which was used to calculate specificity (a measure of a medical test’s ability to correctly identify people who do not have a disease) at different AI sensitivities.

Two chest radiologists, who were blinded to the AI output, labeled the chest X-rays as “remarkable” or “unremarkable” based on predefined unremarkable findings. Chest X-rays with missed findings by AI and/or the radiology report were graded by one chest radiologist – blinded to whether the mistake was made by AI or radiologist – as critical, clinically significant or clinically insignificant.

The reference standard labeled 1,231 of 1,961 chest X-rays (62.8%) as remarkable and 730 of 1,961 (37.2%) as unremarkable. The AI tool correctly excluded pathology in 24.5%- 52.7% of unremarkable chest X-rays at greater than or equal to 98% sensitivity, with lower rates of critical misses than found in the radiology reports associated with the images.

Source: asamonitor.pub/4dxwfjG