Mac Carthy Taig, Hernández Montilla Ignacio, Aguilar Andy, García Castro Rubén, González Pérez Ana María, Vilas Sueiro Alejandro, Vergara de la Campa Laura, Alfageme Fernando, Medela Alfonso
Department of Clinical Endpoint Innovation, Legit. Health, Bilbao, Spain.
Department of Medical Computer Vision and PROMs, Legit.Health, Bilbao, Spain.
JID Innov. 2023 Jul 12;4(1):100218. doi: 10.1016/j.xjidi.2023.100218. eCollection 2024 Jan.
Chronic urticaria is a chronic skin disease that affects up to 1% of the general population worldwide, with chronic spontaneous urticaria accounting for more than two-thirds of all chronic urticaria cases. The Urticaria Activity Score (UAS) is a dynamic severity assessment tool that can be incorporated into daily clinical practice, as well as clinical trials for treatments. The UAS helps in measuring disease severity and guiding the therapeutic strategy. However, UAS assessment is a time-consuming and manual process, with high interobserver variability and high dependence on the observer. To tackle this issue, we introduce Automatic UAS, an automatic equivalent of UAS that deploys a deep learning, lesion-detecting model called Legit.Health-UAS-HiveNet. Our results show that our model assesses the severity of chronic urticaria cases with a performance comparable to that of expert physicians. Furthermore, the model can be implemented into CADx systems to support doctors in their clinical practice and act as a new end point in clinical trials. This proves the usefulness of artificial intelligence in the practice of evidence-based medicine; models trained on the consensus of large clinical boards have the potential of empowering clinicians in their daily practice and replacing current standard clinical end points in clinical trials.
慢性荨麻疹是一种慢性皮肤病,全球高达1%的普通人群受其影响,其中慢性自发性荨麻疹占所有慢性荨麻疹病例的三分之二以上。荨麻疹活动评分(UAS)是一种动态严重程度评估工具,可纳入日常临床实践以及治疗的临床试验中。UAS有助于衡量疾病严重程度并指导治疗策略。然而,UAS评估是一个耗时的手动过程,观察者间差异大且高度依赖观察者。为解决这个问题,我们引入了自动UAS,它是UAS的自动等效物,采用了一种名为Legit.Health-UAS-HiveNet的深度学习病变检测模型。我们的结果表明,我们的模型评估慢性荨麻疹病例严重程度的表现与专家医生相当。此外,该模型可应用于计算机辅助诊断(CADx)系统,以支持医生的临床实践,并作为临床试验中的一个新终点。这证明了人工智能在循证医学实践中的有用性;基于大型临床委员会共识训练的模型有潜力在日常实践中增强临床医生的能力,并取代临床试验中当前的标准临床终点。