A Novel Artificial Intelligence System for Endotracheal Intubation.

Objective:Adequate visualization of the glottic opening is a key factor to successful endotracheal intubation (ETI); however, few objective tools exist to help guide providers’ ETI attempts toward the glottic opening in real-time. Machine learning/artificial intelligence has helped to automate the d...

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Publicado en:Prehospital Emergency Care Vol. 20; no. 5; pp. 667 - 672
Autores principales: Carlson, Jestin N., Das, Samarjit, De la Torre, Fernando, Frisch, Adam, Guyette, Francis X., Hodgins, Jessica K., Yealy, Donald M.
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd Sep/Oct2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep/Oct2016
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      pub: Taylor & Francis Ltd
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        10.3109/10903127.2016.1139220
        117877361
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        atl: A Novel Artificial Intelligence System for Endotracheal Intubation.
      aug:
        au:
          Carlson, Jestin N.
          Das, Samarjit
          De la Torre, Fernando
          Frisch, Adam
          Guyette, Francis X.
          Hodgins, Jessica K.
          Yealy, Donald M.
      sug:
        subj:
          Diffusion of Innovation
          Intubation, Intratracheal Methods
          Technology, Medical
          Guided Imagery
          Glottis Anatomy and Histology
          Automation
          Research Subject Recruitment
          Physicians, Emergency
          Emergency Medical Technicians
          Videorecording
          Laryngoscopy
          Computer Systems
          Signal Processing, Computer Assisted Methods
          Cross Sectional Studies
      ab: Objective:Adequate visualization of the glottic opening is a key factor to successful endotracheal intubation (ETI); however, few objective tools exist to help guide providers’ ETI attempts toward the glottic opening in real-time. Machine learning/artificial intelligence has helped to automate the detection of other visual structures but its utility with ETI is unknown. We sought to test the accuracy of various computer algorithms in identifying the glottic opening, creating a tool that could aid successful intubation. Methods:We collected a convenience sample of providers who each performed ETI 10 times on a mannequin using a video laryngoscope (C-MAC, Karl Storz Corp, Tuttlingen, Germany). We recorded each attempt and reviewed one-second time intervals for the presence or absence of the glottic opening. Four different machine learning/artificial intelligence algorithms analyzed each attempt and time point: k-nearest neighbor (KNN), support vector machine (SVM), decision trees, and neural networks (NN). We used half of the videos to train the algorithms and the second half to test the accuracy, sensitivity, and specificity of each algorithm.Results:We enrolled seven providers, three Emergency Medicine attendings, and four paramedic students. From the 70 total recorded laryngoscopic video attempts, we created 2,465 time intervals. The algorithms had the following sensitivity and specificity for detecting the glottic opening: KNN (70%, 90%), SVM (70%, 90%), decision trees (68%, 80%), and NN (72%, 78%).Conclusions:Initial efforts at computer algorithms using artificial intelligence are able to identify the glottic opening with over 80% accuracy. With further refinements, video laryngoscopy has the potential to provide real-time, direction feedback to the provider to help guide successful ETI.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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