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Firima E, Gonzalez L, Manthabiseng M, Bane M, Lukau B, Leigh B, Kaufmann BA, Weisser M, Amstutz A, Tromp J, Labhardt ND, Burkard T. Implementing focused echocardiography and AI-supported analysis in a population-based survey in Lesotho: implications for community-based cardiovascular disease care models. Hypertens Res 2024; 47:708-713. [PMID: 38228749 PMCID: PMC10912015 DOI: 10.1038/s41440-023-01559-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/23/2023] [Accepted: 12/02/2023] [Indexed: 01/18/2024]
Abstract
In settings where access to expert echocardiography is limited, focused echocardiography, combined with artificial intelligence (AI)-supported analysis, may improve diagnosis and monitoring of left ventricular hypertrophy (LVH). Sixteen nurses/nurse-assistants without prior experience in echocardiography underwent a 2-day hands-on intensive training to learn how to assess parasternal long axis views (PLAX) using an inexpensive hand-held ultrasound device in Lesotho, Southern Africa. Loops were stored on a cloud-drive, analyzed using deep learning algorithms at the University Hospital Basel, and afterwards confirmed by a board-certified cardiologist. The nurses/nurse-assistants obtained 756 echocardiograms. Of the 754 uploaded image files, 628 (83.3%) were evaluable by deep learning algorithms. Of those, results of 514/628 (81.9%) were confirmed by a cardiologist. Of the 126 not evaluable by the AI algorithm, 46 (36.5%) were manually evaluable. Overall, 660 (87.5%) uploaded files were evaluable and confirmed. Following short-term training of nursing cadres, a high proportion of obtained PLAX was evaluable using AI-supported analysis. This could be a basis for AI- and telemedical support in hard-to-reach areas with minimal resources.
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Affiliation(s)
- Emmanuel Firima
- Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | - Lucia Gonzalez
- Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | | | | | - Bailah Leigh
- University of Sierra Leone, Freetown, Sierra Leone
| | - Beat A Kaufmann
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
| | - Maja Weisser
- University of Basel, Basel, Switzerland
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital, Basel, Switzerland
- Ifakara Health Institute, Ifakara, Tanzania
| | - Alain Amstutz
- Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jasper Tromp
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Niklaus Daniel Labhardt
- Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Thilo Burkard
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, Basel, Switzerland
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