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机器学习会是房颤筛查的未来方向吗?

Is machine learning the future for atrial fibrillation screening?

作者信息

Sivanandarajah Pavidra, Wu Huiyi, Bajaj Nikesh, Khan Sadia, Ng Fu Siong

机构信息

National Heart and Lung Institute, Imperial College London, London, United Kingdom.

Chelsea and Westminster NHS Foundation Trust, London, United Kingdom.

出版信息

Cardiovasc Digit Health J. 2022 May 16;3(3):136-145. doi: 10.1016/j.cvdhj.2022.04.001. eCollection 2022 Jun.

DOI:10.1016/j.cvdhj.2022.04.001
PMID:35720677
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9204790/
Abstract

Atrial fibrillation (AF) is the most common arrhythmia and causes significant morbidity and mortality. Early identification of AF may lead to early treatment of AF and may thus prevent AF-related strokes and complications. However, there is no current formal, cost-effective strategy for population screening for AF. In this review, we give a brief overview of targeted screening for AF, AF risk score models used for screening and describe the different screening tools. We then go on to extensively discuss the potential applications of machine learning in AF screening.

摘要

心房颤动(AF)是最常见的心律失常,会导致严重的发病率和死亡率。早期识别房颤可能会带来房颤的早期治疗,从而预防与房颤相关的中风和并发症。然而,目前尚无针对人群进行房颤筛查的正式且具有成本效益的策略。在本综述中,我们简要概述了房颤的靶向筛查、用于筛查的房颤风险评分模型,并描述了不同的筛查工具。接着,我们将广泛讨论机器学习在房颤筛查中的潜在应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/311d/9204790/5dfaf30ca345/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/311d/9204790/5dfaf30ca345/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/311d/9204790/5dfaf30ca345/gr1.jpg

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1
Is machine learning the future for atrial fibrillation screening?机器学习会是房颤筛查的未来方向吗?
Cardiovasc Digit Health J. 2022 May 16;3(3):136-145. doi: 10.1016/j.cvdhj.2022.04.001. eCollection 2022 Jun.
2
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Cost-effectiveness of targeted screening for the identification of patients with atrial fibrillation: evaluation of a machine learning risk prediction algorithm.基于机器学习风险预测算法的心房颤动患者靶向筛查的成本效益评估。
J Med Econ. 2020 Apr;23(4):386-393. doi: 10.1080/13696998.2019.1706543. Epub 2020 Jan 10.
4
Innovative approaches to atrial fibrillation prediction: should polygenic scores and machine learning be implemented in clinical practice?创新的心房颤动预测方法:多基因评分和机器学习是否应在临床实践中应用?
Europace. 2024 Aug 3;26(8). doi: 10.1093/europace/euae201.
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An ECG-based machine learning model for predicting new-onset atrial fibrillation is superior to age and clinical features in identifying patients at high stroke risk.一种基于心电图的预测新发房颤的机器学习模型在识别高卒中风险患者方面优于年龄和临床特征。
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Validation, bias assessment, and optimization of the UNAFIED 2-year risk prediction model for undiagnosed atrial fibrillation using national electronic health data.使用国家电子健康数据对未诊断心房颤动的UNAFIED 2年风险预测模型进行验证、偏倚评估和优化。
Heart Rhythm O2. 2024 Sep 26;5(12):925-935. doi: 10.1016/j.hroo.2024.09.010. eCollection 2024 Dec.
3

本文引用的文献

1
Accuracy of Physicians Interpreting Photoplethysmography and Electrocardiography Tracings to Detect Atrial Fibrillation: INTERPRET-AF.医生解读光电容积脉搏波描记图和心电图描记以检测心房颤动的准确性:INTERPRET-AF研究。
Front Cardiovasc Med. 2021 Sep 20;8:734737. doi: 10.3389/fcvm.2021.734737. eCollection 2021.
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Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial.植入式循环记录仪检测心房颤动以预防卒中(LOOP研究):一项随机对照试验
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高血压中的表观遗传特征
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Current and Future Use of Artificial Intelligence in Electrocardiography.人工智能在心电图中的当前及未来应用
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系统筛查心房颤动(STROKESTOP)的临床结局:一项多中心、平行组、非盲、随机对照试验。
Lancet. 2021 Oct 23;398(10310):1498-1506. doi: 10.1016/S0140-6736(21)01637-8. Epub 2021 Aug 29.
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Clinical Risk Score for the Prediction of Incident Atrial Fibrillation: Derivation in 7 220 654 Taiwan Patients With 438 930 Incident Atrial Fibrillations During a 16-Year Follow-Up.临床房颤风险评分预测:在 16 年的随访中,对台湾 7220654 例患者中的 438930 例房颤患者进行的推导。
J Am Heart Assoc. 2021 Sep 7;10(17):e020194. doi: 10.1161/JAHA.120.020194. Epub 2021 Aug 28.
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Evaluation of the Feasibility and Efficacy of a Novel Device for Screening Silent Atrial Fibrillation (MYBEAT Trial).评估一种新型筛查无症状心房颤动设备的可行性和疗效(MYBEAT 试验)。
Circ J. 2022 Jan 25;86(2):182-188. doi: 10.1253/circj.CJ-20-1061. Epub 2021 Jun 18.
6
Application of a machine learning algorithm for detection of atrial fibrillation in secondary care.一种机器学习算法在二级医疗保健中检测心房颤动的应用。
Int J Cardiol Heart Vasc. 2020 Nov 29;31:100674. doi: 10.1016/j.ijcha.2020.100674. eCollection 2020 Dec.
7
Detecting undiagnosed atrial fibrillation in UK primary care: Validation of a machine learning prediction algorithm in a retrospective cohort study.在英国初级保健中检测未诊断的心房颤动:回顾性队列研究中机器学习预测算法的验证。
Eur J Prev Cardiol. 2021 May 22;28(6):598-605. doi: 10.1177/2047487320942338.
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Development, validation, and proof-of-concept implementation of a two-year risk prediction model for undiagnosed atrial fibrillation using common electronic health data (UNAFIED).使用常见电子健康数据(UNAFIED)开发、验证和概念验证实施一种用于未诊断心房颤动的两年风险预测模型。
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Deep Neural Networks Can Predict New-Onset Atrial Fibrillation From the 12-Lead ECG and Help Identify Those at Risk of Atrial Fibrillation-Related Stroke.深度神经网络可通过 12 导联心电图预测新发心房颤动,并有助于识别心房颤动相关卒中风险。
Circulation. 2021 Mar 30;143(13):1287-1298. doi: 10.1161/CIRCULATIONAHA.120.047829. Epub 2021 Feb 16.
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Performance of Atrial Fibrillation Risk Prediction Models in Over 4 Million Individuals.超过 400 万人的房颤风险预测模型表现。
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