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Clinical Impact of an AI Decision Support System for Detection of Intracranial Hemorrhage in CT Scans
Department of Neurosciences, Neurosurgery, Uppsala University Hospital, Uppsala, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Neuroradiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Neuroradiology.ORCID iD: 0000-0002-5221-2721
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Neuroradiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
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2024 (English)In: NEUROTRAUMA REPORTS, ISSN 2689-288X, Vol. 5, no 1, p. 1009-1015Article in journal (Refereed) Published
Abstract [en]

This study aimed to evaluate the predictive value and clinical impact of a clinically implemented artificial neural network software model. The software detects intracranial hemorrhage (ICH) from head computed tomography (CT) scans and artificial intelligence (AI)-identified positive cases are then annotated in the work list for early radiologist evaluation. The index test was AI detection by the program Zebra Medical Vision-HealthICH+. Radiologist-confirmed ICH was the reference standard. The study compared whether time benefits from using the AI model led to faster escalation of patient care or surgery within the first 24 h. A total of 2,306 patients were evaluated by the software, and 288 AI-positive cases were included. The AI tool had a positive predictive value of 0.823. There was, however, no significant time reduction when comparing the patients who required escalation of care and those who did not. There was also no significant time reduction in those who required acute surgery compared with those who did not. Among the individual patients with reduced time delay, no cases with evident clinical benefit were identified. Although the clinically implemented AI-based decision support system showed adequate predictive value in identifying ICH, there was no significant clinical benefit for the patients in our setting. While AI-assisted detection of ICH shows great promise from a technical perspective, there remains a need to evaluate the clinical impact and perform external validation across different settings.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2024. Vol. 5, no 1, p. 1009-1015
Keywords [en]
CNS, ICH, AI model, decision analysis, outcome analysis
National Category
Neurology Surgery
Identifiers
URN: urn:nbn:se:uu:diva-541286DOI: 10.1089/neur.2024.0017ISI: 001330511100001PubMedID: 39440151OAI: oai:DiVA.org:uu-541286DiVA, id: diva2:1909454
Available from: 2024-10-30 Created: 2024-10-30 Last updated: 2025-10-14Bibliographically approved

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Toumpanakis, DimitriosFällmar, David

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