Artificial intelligence could prevent unnecessary tests in patients with chest pain

A recent study showed artificial intelligence (AI) may prevent 'unnecessary examination' in patients with stable chest pain, a frequent cause of visits to emergency departments and general practitioners.

The study was presented at The International Conference on Nuclear Cardiology and Cardiac CT (ICNC) 2019.

Study author Dr Marco Mazzanti, Royal Brompton Hospital said, "We know that doctors overtest patients and ignore recommendations when a test justified about two-thirds of the time. Our 'super brain' decision support system, called ARTICA does not advise unnecessary examinations."

ARTICA, which stands for Artificial Intelligence for clinical Cardiac Navigation, is a decision support system created by the researchers. It uses machine learning, a type of AI, to make decisions that adhere to recommended practice.

The study enrolled 982 patients with stable chest pain.

The researchers compared decisions on which tests to perform made by a cardiologist and by ARTICA on the same day. ARTICA advised no further testing in 658 (67 per cent) patients whereas a cardiologist decided that only 45 (4.6per cent) patients did not need more tests.

A computed tomography angiography (CTA) scan showed that 639 (97 per cent) of the patients ARTICA said did not need tests had no significant coronary artery disease, meaning the decision was correct. Avoiding these tests would save staff one hour and patients two hours on average.

Dr Mazzanti said, "AI has the potential to save costs and staff time by identifying patients with chest pain who do not have significant coronary artery disease and therefore do not need expensive cardiac imaging."

"As doctors, we order a lot of tests which cost a lot of money and waste time. ARTICA is like a second set of eyes to make sure we follow recommendations," added Dr Mazzanti.

He noted that ARTICA recommended exercise testing or functional imaging for 224 (23 per cent) patients while cardiologists recommended it for just 100 (10 per cent) patients.

"We know that when ARTICA says don't do a test it is almost 100 per cent right because the CTA scan confirmed no blocked arteries," said Dr Mazzanti.

"When ARTICA decides a test is needed, we are less certain that this is correct. By adding more data to the super brain these decisions will become more accurate and enable us to deliver more personalised care," Dr Mazzanti added.