General practitioners using AI-enhanced point-of-care ultrasound achieved high diagnostic agreement (kappa 0.78) and sensitivity (0.87) for detecting carotid plaque compared to expert ultrasonologists.
Cross-Sectional (n=169)
Single-blind
Yes
Does AI-enhanced POCUS performed by systematically trained general practitioners accurately detect carotid plaque in patients with high ASCVD risk?
Systematically trained general practitioners can effectively and accurately perform carotid plaque screening using AI-enhanced POCUS in high-risk elderly populations.
Effect estimate: Kappa 0.78 (95% CI 0.69-0.88)
PURPOSE While point-of-care ultrasound (POCUS) has been integrated into daily practice by general practitioners (GPs) in some countries, there is a paucity of literature documenting its use by Chinese GPs. Additionally, artificial intelligence (AI)-assisted diagnosis is increasingly applied to imaging equipment. This study aims to explore the diagnostic performance of GPs in carotid plaque detection using AI-enhanced POCUS after systematic training. METHODS This diagnostic accuracy trial was conducted in Shanghai, where 7 GPs received systematic training then recruited patients with high atherosclerotic cardiovascular disease risk during outpatient visits for free carotid plaque screening. We comprehensively evaluated their diagnostic performance using 2 approaches: per-patient (ie, assessed whether patients had any carotid plaque) and per-vessel (ie, determined plaque presence in any carotid vessel). Evaluation metrics included sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the κ statistic for agreement. RESULTS A total of 169 patients (mean age 69.6 years SD 5.76; 37.9% male) were included in this study. At the per-patient level, sensitivity was 0.87 (95% CI, 0.80-0.95); specificity was 0.91 (95% CI, 0.86-0.97); PPV was 0.89 (95% CI, 0.82-0.96); NPV was 0.89 (95% CI, 0.83-0.96); and the κ value was 0.78 (95% CI, 0.69-0.88), indicating high agreement with the gold standard. The diagnostic performance evaluated at the per-vessel level was comparable to that at the per-patient level. CONCLUSION Our findings indicate that, after systematic training, GPs can effectively perform carotid plaque screening using AI-enhanced POCUS within a clinical workflow in high-risk elderly populations.
Liu et al. (Fri,) conducted a cross-sectional in High atherosclerotic cardiovascular disease (ASCVD) risk (n=169). AI-enhanced point-of-care ultrasound (POCUS) vs. Expert ultrasonologist review was evaluated on Per-patient carotid plaque detection agreement (Kappa 0.78, 95% CI 0.69-0.88). General practitioners using AI-enhanced point-of-care ultrasound achieved high diagnostic agreement (kappa 0.78) and sensitivity (0.87) for detecting carotid plaque compared to expert ultrasonologists.