血管医学中的机器学习:优化外周动脉疾病的临床策略。

IF 2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Current Cardiovascular Risk Reports Pub Date : 2024-01-01 Epub Date: 2024-11-04 DOI:10.1007/s12170-024-00752-7
Sean Perez, Sneha Thandra, Ines Mellah, Laura Kraemer, Elsie Ross
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引用次数: 0

摘要

综述的目的:外周动脉疾病(PAD)是一种影响数百万患者的疾病,由于早期缺乏症状,往往诊断不足,而且由于遗传和表型特征的差异,治疗可能很复杂。本综述旨在向读者介绍机器学习(ML)在并发心肌梗塞(PAD)管理中的最新应用:最近的研究利用电子健康记录 (EHR) 数据和 ML 算法证明了自动化系统(即人工智能 (AI))在准确识别可能从进一步 PAD 筛查中受益的患者方面的潜在应用取得了重大进展。此外,深度学习算法还可用于成像数据,以协助 PAD 诊断并自动进行临床风险分层。ML 模型可以相当准确地预测主要不良心血管事件 (MACE) 和主要不良肢体事件 (MALE),许多研究还表明它能够更准确地对手术干预后出现有害结果的患者进行风险分层。这些预测可以帮助医生制定更加以患者为中心的治疗计划,并对高危患者中可改变的风险因素进行更早、更积极的管理。在 ML 模型中使用蛋白质组生物标志物为传统的筛查和分层范例提供了有价值的补充,尽管临床实用性可能会受到成本和可及性的限制。摘要:将人工智能应用于 PAD 患者的治疗,可以利用现成的 EHR 和成像数据,实现更早的诊断和更准确的风险分层,而且人们对纳入生物数据以进一步完善的兴趣也在不断增长。因此,PAD 精准治疗的希望越来越近了。未来的研究应侧重于通过将这些模型真实地融入临床实践来验证它们,并对这种新护理模式的影响进行前瞻性评估。
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Machine Learning in Vascular Medicine: Optimizing Clinical Strategies for Peripheral Artery Disease.

Purpose of review: Peripheral Artery Disease (PAD), a condition affecting millions of patients, is often underdiagnosed due to a lack of symptoms in the early stages and management can be complex given differences in genetic and phenotypic characteristics. This review aims to provide readers with an update on the utility of machine learning (ML) in the management of PAD.

Recent findings: Recent research leveraging electronic health record (EHR) data and ML algorithms have demonstrated significant advances in the potential use of automated systems, namely artificial intelligence (AI), to accurately identify patients who might benefit from further PAD screening. Additionally, deep learning algorithms can be used on imaging data to assist in PAD diagnosis and automate clinical risk stratification.ML models can predict major adverse cardiovascular events (MACE) and major adverse limb events (MALE) with considerable accuracy, with many studies also demonstrating the ability to more accurately risk stratify patients for deleterious outcomes after surgical intervention. These predictions can assist physicians in developing more patient-centric treatment plans and allow for earlier, more aggressive management of modifiable risk-factors in high-risk patients. The use of proteomic biomarkers in ML models offers a valuable addition to traditional screening and stratification paradigms, though clinical utility may be limited by cost and accessibility.

Summary: The application of AI to the care of PAD patients may enable earlier diagnosis and more accurate risk stratification, leveraging readily available EHR and imaging data, and there is a burgeoning interest in incorporating biological data for further refinement. Thus, the promise of precision PAD care grows closer. Future research should focus on validating these models via real-world integration into clinical practice and prospective evaluation of the impact of this new care paradigm.

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来源期刊
Current Cardiovascular Risk Reports
Current Cardiovascular Risk Reports CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.00
自引率
0.00%
发文量
23
期刊介绍: The aim of this journal is to keep readers informed by providing cutting-edge reviews on key topics pertaining to cardiovascular risk. We use a systematic approach: international experts prepare timely articles on relevant topics that highlight the most important recent original publications. We accomplish this aim by appointing Section Editors in major subject areas across the discipline of cardiovascular medicine to select topics for review articles by leading experts who emphasize recent developments and highlight important papers published in the past year. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.
期刊最新文献
Racial and Ethnic Disparities in Peri-and Post-operative Cardiac Surgery. Diagnosis and Management of Hypertension in Adolescents with Obesity. Machine Learning in Vascular Medicine: Optimizing Clinical Strategies for Peripheral Artery Disease. Assisted Reproductive Technology and Cardiovascular Risk in Women Obesity Management Solutions in Rural Communities
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