1
|
Snowdon JL, Scheufele EL, Pritts J, Le PT, Mensah GA, Zhang X, Dankwa-Mullan I. Evaluating Social Determinants of Health Variables in Advanced Analytic and Artificial Intelligence Models for Cardiovascular Disease Risk and Outcomes: A Targeted Review. Ethn Dis 2023; 33:33-43. [PMID: 38846264 PMCID: PMC11152155 DOI: 10.18865/1704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Introduction/Purpose Predictive models incorporating relevant clinical and social features can provide meaningful insights into complex interrelated mechanisms of cardiovascular disease (CVD) risk and progression and the influence of environmental exposures on adverse outcomes. The purpose of this targeted review (2018-2019) was to examine the extent to which present-day advanced analytics, artificial intelligence, and machine learning models include relevant variables to address potential biases that inform care, treatment, resource allocation, and management of patients with CVD. Methods PubMed literature was searched using the prespecified inclusion and exclusion criteria to identify and critically evaluate primary studies published in English that reported on predictive models for CVD, associated risks, progression, and outcomes in the general adult population in North America. Studies were then assessed for inclusion of relevant social variables in the model construction. Two independent reviewers screened articles for eligibility. Primary and secondary independent reviewers extracted information from each full-text article for analysis. Disagreements were resolved with a third reviewer and iterative screening rounds to establish consensus. Cohen's kappa was used to determine interrater reliability. Results The review yielded 533 unique records where 35 met the inclusion criteria. Studies used advanced statistical and machine learning methods to predict CVD risk (10, 29%), mortality (19, 54%), survival (7, 20%), complication (10, 29%), disease progression (6, 17%), functional outcomes (4, 11%), and disposition (2, 6%). Most studies incorporated age (34, 97%), sex (34, 97%), comorbid conditions (32, 91%), and behavioral risk factor (28, 80%) variables. Race or ethnicity (23, 66%) and social variables, such as education (3, 9%) were less frequently observed. Conclusions Predictive models should adjust for race and social predictor variables, where relevant, to improve model accuracy and to inform more equitable interventions and decision making.
Collapse
Affiliation(s)
- Jane L. Snowdon
- Center for Artificial Intelligence, Research, and Evaluation, IBM Watson Health, Cambridge, MA 02142
| | - Elisabeth L. Scheufele
- Center for Artificial Intelligence, Research, and Evaluation, IBM Watson Health, Cambridge, MA 02142
| | - Jill Pritts
- Center for Artificial Intelligence, Research, and Evaluation, IBM Watson Health, Cambridge, MA 02142
| | - Phuong-Tu Le
- Division of Integrative Biological and Behavioral Sciences, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD 20892
| | - George A. Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Xinzhi Zhang
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Irene Dankwa-Mullan
- Center for Artificial Intelligence, Research, and Evaluation, IBM Watson Health, Cambridge, MA 02142
| |
Collapse
|
2
|
Rizi FY, Au J, Yli-Ollila H, Golemati S, Makūnaitė M, Orkisz M, Navab N, MacDonald M, Laitinen TM, Behnam H, Gao Z, Gastounioti A, Jurkonis R, Vray D, Laitinen T, Sérusclat A, Nikita KS, Zahnd G. Carotid Wall Longitudinal Motion in Ultrasound Imaging: An Expert Consensus Review. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2605-2624. [PMID: 32709520 DOI: 10.1016/j.ultrasmedbio.2020.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 06/01/2020] [Accepted: 06/07/2020] [Indexed: 06/11/2023]
Abstract
Motion extracted from the carotid artery wall provides unique information for vascular health evaluation. Carotid artery longitudinal wall motion corresponds to the multiphasic arterial wall excursion in the direction parallel to blood flow during the cardiac cycle. While this motion phenomenon has been well characterized, there is a general lack of awareness regarding its implications for vascular health assessment or even basic vascular physiology. In the last decade, novel estimation strategies and clinical investigations have greatly advanced our understanding of the bi-axial behavior of the carotid artery, necessitating an up-to-date review to summarize and classify the published literature in collaboration with technical and clinical experts in the field. Within this review, the state-of-the-art methodologies for carotid wall motion estimation are described, and the observed relationships between longitudinal motion-derived indices and vascular health are reported. The vast number of studies describing the longitudinal motion pattern in plaque-free arteries, with its putative application to cardiovascular disease prediction, point to the need for characterizing the added value and applicability of longitudinal motion beyond established biomarkers. To this aim, the main purpose of this review was to provide a strong base of theoretical knowledge, together with a curated set of practical guidelines and recommendations for longitudinal motion estimation in patients, to foster future discoveries in the field, toward the integration of longitudinal motion in basic science as well as clinical practice.
Collapse
Affiliation(s)
- Fereshteh Yousefi Rizi
- School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.
| | - Jason Au
- Schlegel Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada
| | - Heikki Yli-Ollila
- Department of Radiology, Kanta-Häme Central Hospital, Hämeenlinna, Finland; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Spyretta Golemati
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Monika Makūnaitė
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Maciej Orkisz
- Univ Lyon, Université Claude Bernard Lyon 1, INSA-Lyon, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621 Villeurbanne cedex, France
| | - Nassir Navab
- Computer Aided Medical Procedures, Technische Universität München, Garching bei München, Germany; Computer Aided Medical Procedures, Johns Hopkins University, Baltimore, Maryland, USA
| | - Maureen MacDonald
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Tiina Marja Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Hamid Behnam
- Biomedical Engineering Department, School of Electrical Engineering, Iran University of Science and Technology (IUST), Tehran, Iran
| | - Zhifan Gao
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Aimilia Gastounioti
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rytis Jurkonis
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Didier Vray
- Univ Lyon, Université Claude Bernard Lyon 1, INSA-Lyon, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621 Villeurbanne cedex, France
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - André Sérusclat
- Department of Radiology, Louis Pradel Hospital; Hospices Civils de Lyon; Université Lyon 1, Lyon, France
| | - Konstantina S Nikita
- Biomedical Simulations and Imaging Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Guillaume Zahnd
- Computer Aided Medical Procedures, Technische Universität München, Garching bei München, Germany
| |
Collapse
|