Artificial Intelligence

Creating A Novice Heart Failure Screening Pathway

We hear a lot about AI’s potential to expand echocardiography to far more users and clinical settings, and a new study out of Singapore suggests that echo’s AI-driven expansion might go far beyond what many of us had in mind.

The PANES-HF trial set up a home-based echo heart failure screening program that equipped a team of complete novices (no experience with echo, or in healthcare) with EchoNous’s AI-guided handheld ultrasound system and Us2.ai’s AI-automated echo analysis and reporting solution.

After just two weeks of training, the novices performed at-home echocardiography exams on 100 patients with suspected heart failure, completing the studies in an average of 11.5 minutes per patient.

When compared to the same 100 patients’ NT-proBNP blood test results and reference standard echo exams (expert sonographers, cart-based echo systems, and cardiologist interpretations), the novice echo AI pathway…

  • Yielded interpretable results in 96 patients 
  • Improved risk prediction accuracy versus NT-proBNP by 30% 
  • Detected abnormal LVEF <50% scans with an 0.880 AUC (vs. NT-proBNP’s 0.651-0.690 AUCs)
  • Achieved good agreement with expert clinicians for LVEF<50% detection (k=0.742)

These findings were strong enough for the authors to suggest that emerging ultrasound and AI technologies will enable healthcare organizations to create completely new heart failure echocardiography pathways. That might start with task-shifting from cardiologists to primary care, but could extend to novice-performed exams and home-based care.

The Takeaway

Considering the rising prevalence of heart failure, the recent advances in HF treatments, and the continued sonographer shortage, there’s clearly a need for more accessible and efficient echo pathways — and this study is arguably the strongest evidence that AI might be at the center of those new pathways.

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