Artificial Intelligence Driven Prehospital ECG Interpretation for the Reduction of False Positive Emergent Cardiac Catheterization Lab Activations: A Retrospective Cohort Study.
Objectives: Data suggest patients suffering acute coronary occlusion myocardial infarction (OMI) benefit from prompt primary percutaneous intervention (PPCI). Many emergency medical services (EMS) activate catheterization labs to reduce time to PPCI, but suffer a high burden of inappropriate activat...
| Publicado en: | Prehospital Emergency Care Vol. 29; no. 3; pp. 218 - 227 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts tracings Journal Article |
| Publicado: |
Taylor & Francis Ltd
2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=184297742&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 184297742 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10903127 FZB jtl: Prehospital Emergency Care issn: 10903127 maglogo: Y pubinfo: dt: 2025 vid: 29 iid: 3 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 184297742 179450232 184297742 184297742 10.1080/10903127.2024.2399218 184297742 ppf: 218 ppct: 9 formats: tig: atl: Artificial Intelligence Driven Prehospital ECG Interpretation for the Reduction of False Positive Emergent Cardiac Catheterization Lab Activations: A Retrospective Cohort Study. aug: au: Baker, Peter O. Karim, Shifa R. Smith, Stephen W. Meyers, H. Pendell Robinson, Aaron E. Ibtida, Ishmam Karim, Rehan M. Keller, Gabriel A. Royce, Kristie A. Puskarich, Michael A. affil: Department of Emergency Medicine, University of Minnesota Medical School, Minneapolis, Minnesota sug: subj: Coronary Occlusion Diagnosis Myocardial Infarction Diagnosis Electrocardiography Methods Heart Catheterization Artificial Intelligence Emergency Medical Services False Positive Results Human Male Female Middle Age Retrospective Design Record Review Prospective Studies Algorithms Coronary Angiography Troponin Blood Confidence Intervals Statistical Significance Data Analysis Software Descriptive Statistics Middle Aged: 45-64 years Male Female ab: Objectives: Data suggest patients suffering acute coronary occlusion myocardial infarction (OMI) benefit from prompt primary percutaneous intervention (PPCI). Many emergency medical services (EMS) activate catheterization labs to reduce time to PPCI, but suffer a high burden of inappropriate activations. Artificial intelligence (AI) algorithms show promise to improve electrocardiogram (ECG) interpretation. The primary objective was to evaluate the potential of AI to reduce false positive activations without missing OMI. Methods: Electrocardiograms were categorized by (1) STEMI criteria, (2) ECG integrated device software and (3) a proprietary AI algorithm (Queen of Hearts (QOH), Powerful Medical). If multiple ECGs were obtained and any one tracing was positive for a given method, that diagnostic method was considered positive. The primary outcome was OMI defined as an angiographic culprit lesion with either TIMI 0–2 flow; or TIMI 3 flow with either peak high sensitivity troponin-I > 5000 ng/L or new wall motion abnormality. The primary analysis was per-patient proportion of false positives. Results: A total of 140 patients were screened and 117 met criteria. Of these, 48 met the primary outcome criteria of OMI. There were 80 positives by STEMI criteria, 88 by device algorithm, and 77 by AI software. All approaches reduced false positives, 27% for STEMI, 22% for device software, and 34% for AI (p < 0.01 for all). The reduction in false positives did not significantly differ between STEMI criteria and AI software (p = 0.19) but STEMI criteria missed 6 (5%) OMIs, while AI missed none (p = 0.01). Conclusions: In this single-center retrospective study, an AI-driven algorithm reduced false positive diagnoses of OMI compared to EMS clinician gestalt. Compared to AI (which missed no OMI), STEMI criteria also reduced false positives but missed 6 true OMI. External validation of these findings in prospective cohorts is indicated. pubtype: Academic Journal doctype: research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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