Clinical Impact of an AI Decision Support System for Detection of Intracranial Hemorrhage in CT Scans

This study aimed to evaluate the predictive value and clinical impact of a clinically implemented artificial neural network software model. The software detects intracranial hemorrhage (ICH) from head computed tomography (CT) scans and artificial intelligence (AI)-identified positive cases are then...

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Main Authors: David Bark, Julia Basu, Dimitrios Toumpanakis, Johan Burwick Nyberg, Tomas Bjerner, Elham Rostami, David Fällmar
Format: Article
Language:English
Published: Mary Ann Liebert 2024-11-01
Series:Neurotrauma Reports
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Online Access:https://www.liebertpub.com/doi/10.1089/neur.2024.0017
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author David Bark
Julia Basu
Dimitrios Toumpanakis
Johan Burwick Nyberg
Tomas Bjerner
Elham Rostami
David Fällmar
author_facet David Bark
Julia Basu
Dimitrios Toumpanakis
Johan Burwick Nyberg
Tomas Bjerner
Elham Rostami
David Fällmar
author_sort David Bark
collection DOAJ
description This study aimed to evaluate the predictive value and clinical impact of a clinically implemented artificial neural network software model. The software detects intracranial hemorrhage (ICH) from head computed tomography (CT) scans and artificial intelligence (AI)-identified positive cases are then annotated in the work list for early radiologist evaluation. The index test was AI detection by the program Zebra Medical Vision—HealthICH+. Radiologist-confirmed ICH was the reference standard. The study compared whether time benefits from using the AI model led to faster escalation of patient care or surgery within the first 24 h. A total of 2,306 patients were evaluated by the software, and 288 AI-positive cases were included. The AI tool had a positive predictive value of 0.823. There was, however, no significant time reduction when comparing the patients who required escalation of care and those who did not. There was also no significant time reduction in those who required acute surgery compared with those who did not. Among the individual patients with reduced time delay, no cases with evident clinical benefit were identified. Although the clinically implemented AI-based decision support system showed adequate predictive value in identifying ICH, there was no significant clinical benefit for the patients in our setting. While AI-assisted detection of ICH shows great promise from a technical perspective, there remains a need to evaluate the clinical impact and perform external validation across different settings.
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spelling doaj-art-0645bfc9b64f4572b0d47297a65ad4ff2025-08-20T03:49:37ZengMary Ann LiebertNeurotrauma Reports2689-288X2024-11-01511009101510.1089/neur.2024.0017Clinical Impact of an AI Decision Support System for Detection of Intracranial Hemorrhage in CT ScansDavid Bark0Julia Basu1Dimitrios Toumpanakis2Johan Burwick Nyberg3Tomas Bjerner4Elham Rostami5David Fällmar6Department of Neurosciences, Neurosurgery, Uppsala University Hospital, Uppsala, Sweden.Department of Surgical Sciences, Neuroradiology, Uppsala University, Uppsala, Sweden.Department of Surgical Sciences, Neuroradiology, Uppsala University, Uppsala, Sweden.Department of Surgical Sciences, Neuroradiology, Uppsala University, Uppsala, Sweden.Department of Radiology in Linköping, Linköping University, Linköping, Sweden.Department of Neurosciences, Neurosurgery, Uppsala University Hospital, Uppsala, Sweden.Department of Surgical Sciences, Neuroradiology, Uppsala University, Uppsala, Sweden.This study aimed to evaluate the predictive value and clinical impact of a clinically implemented artificial neural network software model. The software detects intracranial hemorrhage (ICH) from head computed tomography (CT) scans and artificial intelligence (AI)-identified positive cases are then annotated in the work list for early radiologist evaluation. The index test was AI detection by the program Zebra Medical Vision—HealthICH+. Radiologist-confirmed ICH was the reference standard. The study compared whether time benefits from using the AI model led to faster escalation of patient care or surgery within the first 24 h. A total of 2,306 patients were evaluated by the software, and 288 AI-positive cases were included. The AI tool had a positive predictive value of 0.823. There was, however, no significant time reduction when comparing the patients who required escalation of care and those who did not. There was also no significant time reduction in those who required acute surgery compared with those who did not. Among the individual patients with reduced time delay, no cases with evident clinical benefit were identified. Although the clinically implemented AI-based decision support system showed adequate predictive value in identifying ICH, there was no significant clinical benefit for the patients in our setting. While AI-assisted detection of ICH shows great promise from a technical perspective, there remains a need to evaluate the clinical impact and perform external validation across different settings.https://www.liebertpub.com/doi/10.1089/neur.2024.0017CNSICHAI modeldecision analysisoutcome analysis
spellingShingle David Bark
Julia Basu
Dimitrios Toumpanakis
Johan Burwick Nyberg
Tomas Bjerner
Elham Rostami
David Fällmar
Clinical Impact of an AI Decision Support System for Detection of Intracranial Hemorrhage in CT Scans
Neurotrauma Reports
CNS
ICH
AI model
decision analysis
outcome analysis
title Clinical Impact of an AI Decision Support System for Detection of Intracranial Hemorrhage in CT Scans
title_full Clinical Impact of an AI Decision Support System for Detection of Intracranial Hemorrhage in CT Scans
title_fullStr Clinical Impact of an AI Decision Support System for Detection of Intracranial Hemorrhage in CT Scans
title_full_unstemmed Clinical Impact of an AI Decision Support System for Detection of Intracranial Hemorrhage in CT Scans
title_short Clinical Impact of an AI Decision Support System for Detection of Intracranial Hemorrhage in CT Scans
title_sort clinical impact of an ai decision support system for detection of intracranial hemorrhage in ct scans
topic CNS
ICH
AI model
decision analysis
outcome analysis
url https://www.liebertpub.com/doi/10.1089/neur.2024.0017
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