Artificial Intelligence Guided Echocardiographic Screening of Rare Diseases (EchoNet-Screening)
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 入组人数
- 500
- 试验地点
- 8
- 主要终点
- Positive Predictive Value
研究概览
简要总结
Recent advances in machine learning and image processing techniques have shown that machine learning models can identify features unrecognized by human experts and accurately assess common measurements made in clinical practice. Echocardiography is the most common form of cardiac imaging and is routinely and frequently used for diagnosis. However, there is often subjectivity and heterogeneity in interpretation. Artificial intelligence (AI)'s ability for precision measurement and detection is important in both disease screening as well as diagnosis of cardiovascular disease.
Cardiac amyloidosis (CA) is a rare, underdiagnosed disease with targeted therapies that reduce morbidity and increase life expectancy. However, CA is frequently overlooked and confused with heart failure with preserved ejection fraction. Some estimates suggest that CA can be as prevalence as 1% in a general population, with even higher prevalence in patients with left ventricular hypertrophy, heart failure, and other cardiac symptoms that might prompt echocardiography.
AI guided disease screening workflows have been proposed for rare diseases such as cardiac amyloidosis and other diseases with relatively low prevalence but significant human impact with targeted therapies when detected early. This is an area particularly suitable for AI as there are multiple mimics where diseases like hypertrophic cardiomyopathy, cardiac amyloidosis, aortic stenosis, and other phenotypes might visually be similar but can be distinguished by AI algorithms. The investigators have developed an algorithm, termed EchoNet-LVH, to identify cardiac hypertrophy and identify patients who would benefit from additional screening for cardiac amyloidosis.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 22 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients receiving an echocardiogram that is determined to be suspicious by EchoNet-LVH
排除标准
- •Patients that decline consent
- •Patients receiving an echocardiogram that is determined to be not suspicious by EchoNet-LVH
研究组 & 干预措施
Suspicious by EchoNet-LVH Algorithm
Each potential participant identified by automated AI-enhanced echocardiogram review will be chart reviewed by each site's CA experts for appropriateness of enrollment and clinican suspicion for CA. Based on the judgement of CA experts, potential participants that meet eligibility criteria will be called to be consented, followed in the study, and referred to see the CA expert.
干预措施: EchoNet-LVH Assessment (Diagnostic Test)
结局指标
主要结局
Positive Predictive Value
时间窗: 1 year
1. Among patients that screening positive and consented to the trial, the proportion of patients that subsequently are confirmed to have CA upon clinical follow-up. 2. Statistical Analysis: Fisher's exact (two-sided) for superiority Comparison with PPV of standard clinical suspicion (PPV of all comers that receive Tc-99m PYP/HDP imaging scan or other clinical diagnosis).
次要结局
- Time to Diagnosis from Echocardiogram Study to Clinical Diagnosis(1 year)
- Number of Patients that Receive Treatment for CA(1 year)
- Number of Cardiac Amyloidosis Diagnoses(1 year)
- Number of Participants with All Cause Death(1 year)
- Number of Participants with All Cause Hospitalization(1 year)
- Number of Participants with Heart Failure Hospitalization(1 year)
研究者
Lily Stern
Assistant Professor
Cedars-Sinai Medical Center
