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AI Decision Support System Prevents Unneeded Tests in Patients With Stable Chest Pain

May 24, 2019

By Megan Brooks

NEW YORK (Reuters Health) - A clinical decision support tool powered by artificial intelligence (AI) can prevent unnecessary diagnostic tests in patients with stable chest pain, according to new research.

"We know that doctors over-test patients and ignore recommendations about when a test is justified about two-thirds of the time," said Dr. Marco Mazzanti of the Royal Brompton Hospital, in London, who presented the findings May 12 at The International Conference on Nuclear Cardiology and Cardiac CT (ICNC) in Lisbon, Portugal.

"AI has the potential to save costs and staff time by identifying patients with chest pain who do not have significant coronary-artery disease and therefore do not need expensive cardiac imaging," he told Reuters Health by email. "Our 'super brain' decision support system, called ARTICA, strictly follows European Society of Cardiology (ESC) guidelines."

ARTICA stands for ARTificial Intelligence for clinical Cardiac nAvigation.

The system was tested in 982 patients with stable chest pain. The researchers compared decisions on which tests to perform made by a cardiologist and by ARTICA on the same day. ARTICA advised no further testing in 658 (67%) patients whereas a cardiologist decided that only 45 (4.6%) patients did not need further testing.

A computed tomography angiography (CTA) scan showed that 639 (97%) of the patients ARTICA said did not need tests had no significant coronary-artery disease, meaning the decision was correct.

In addition, ARTICA recommended exercise testing or functional imaging for 224 (23%) patients while cardiologists recommended it for just 100 (10%) patients.

"We know that when ARTICA says don't do a test it is almost 100% right because the CTA scan confirmed no blocked arteries," Dr. Mazzanti noted in a news release from the conference. "When ARTICA decides a test is needed, we are less certain that this is correct. By adding more data to the super brain these decisions will become more accurate and enable us to deliver more personalized care," he added.

"This is the first experience comparing human specialist visit versus robotic software assessment," Dr. Mazzanti told Reuters Health.

"As doctors we order a lot of tests which cost a lot of money and waste time. ARTICA is like a second set of eyes to make sure we follow recommendations towards the possible best precision of care. So I believe the system is absolutely ready for routine use," he said.

The ICNC is co-organized by the American Society of Nuclear Cardiology, the European Association of Cardiovascular Imaging of the European Society of Cardiology and the European Association of Nuclear Medicine.


ICNC 2019.

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