RESUMO
This manuscript reviews the application of artificial intelligence (AI) in acute cardiac care, highlighting its potential to transform patient outcomes in the face of the global burden of cardiovascular diseases. It explores how AI algorithms can rapidly and accurately process data for the prediction and diagnosis of acute cardiac conditions. The paper examines AI's impact on patient health across various diagnostic tools such as echocardiography, electrocardiography, coronary angiography, cardiac CT, and MRI and discusses the regulatory landscape for AI in healthcare, categorizes AI algorithms by their risk levels. Furthermore, it addresses the challenges of data quality, generalizability, bias, transparency, and regulatory considerations, underscoring the necessity for inclusive data and robust validation processes. The review concludes with future perspectives on integrating AI into clinical workflows and the ongoing need for research, regulation, and innovation to harness AI's full potential in improving acute cardiac care.
RESUMO
The potential of artificial intelligence (AI) in medicine lies in its ability to enhance clinicians' capacity to analyze medical images, thereby improving diagnostic precision and accuracy, thus enhancing current tests. However, the integration of AI within healthcare is fraught with difficulties. Heterogeneity among healthcare system applications, reliance on proprietary closed-source software, and rising cyber-security threats pose significant challenges. Moreover, prior to their deployment in clinical settings, AI models must demonstrate their effectiveness across a wide range of scenarios and must be validated by prospective studies, but doing so requires testing in an environment mirroring the clinical workflow which is difficult to achieve without dedicated software. Finally, the use of AI techniques in healthcare raises significant legal and ethical issues, such as the protection of patient privacy, the prevention of bias, and the monitoring of the device's safety and effectiveness for regulatory compliance. This review describes challenges to AI integration in healthcare and provides guidelines on how to move forward. We describe an open-source solution that we developed which integrates AI models into the Picture Archives Communication System (PACS), called PACS-AI. This approach aims to increase the evaluation of AI models by facilitating their integration and validation with existing medical imaging databases. PACS-AI may overcome many current barriers to AI deployment and offers a pathway towards responsible, fair, and effective deployment of AI models in healthcare. Additionally, we propose a list of criteria and guidelines that AI researchers should adopt when publishing a medical AI model, to enhance standardization and reproducibility.
RESUMO
Cardiovascular diseases are the leading cause of death globally and contribute significantly to the cost of healthcare. Artificial intelligence (AI) is poised to reshape cardiology. Using supervised and unsupervised learning, the two main branches of AI, several applications have been developed in recent years to improve risk prediction, allow large-scale analysis of medical data, and phenotype patients for personalized medicine. In this review, we examine the key advances in AI in cardiology and its limitations regarding bias in the data, standardization in reporting, data access, and model trust and accountability in cases of error. Finally, we discuss implementation methods to unleash AI's potential in making healthcare more accurate and efficient. Several steps need to be followed and challenges overcome in order to successfully integrate AI in clinical practice and ensure its longevity.
