Omar Mahmud, Agbareia Reem, Naffaa Mohammad E, Watad Abdulla, Glicksberg Benjamin S, Nadkarni Girish N, Klang Eyal
Icahn School of Medicine at Mount Sinai, New York, New York, and Maccabi Healthcare Services, Tel Aviv, Israel.
Ophthalmology Department, Hadassah Medical Center, Jerusalem, Israel.
ACR Open Rheumatol. 2025 Mar;7(3):e70016. doi: 10.1002/acr2.70016.
Vasculitides are rare inflammatory disorders that sometimes can be difficult to diagnose due to their diverse presentations. This review examines the use of artificial intelligence (AI) to improve diagnosis and outcome prediction in vasculitis.
A systematic search of PubMed, Embase, Web of Science, Institute of Electrical and Electronics Engineers Xplore, and Scopus identified relevant studies from 2000 to 2024. AI applications were categorized by data type (clinical, imaging, textual) and by task (diagnosis or prediction). Studies were assessed for risk of bias using the Prediction Model Risk of Bias Assessment Tool and Quality Assessment of Diagnostic Accuracy Studies-2.
A total of 46 studies were included. AI models achieved high diagnostic performance in Kawasaki disease, with sensitivities up to 92.5% and specificities up to 97.3%. Predictive models for complications, such as intravenous Ig resistance in Kawasaki disease, showed areas under the curves between 0.716 and 0.834. Other vasculitis types, especially those using imaging data, were less studied and often limited by small datasets.
The current literature shows that AI algorithms can enhance vasculitis diagnosis and prediction, with deep- and machine-learning models showing promise in Kawasaki disease. However, broader datasets, more external validation, and the integration of newer models like large language models are needed to advance their clinical applicability across different vasculitis types.
血管炎是罕见的炎症性疾病,有时因其表现多样而难以诊断。本综述探讨了使用人工智能(AI)来改善血管炎的诊断和结局预测。
对PubMed、Embase、Web of Science、电气和电子工程师协会数据库(IEEE Xplore)以及Scopus进行系统检索,以确定2000年至2024年的相关研究。AI应用按数据类型(临床、影像、文本)和任务(诊断或预测)进行分类。使用预测模型偏倚风险评估工具和诊断准确性研究质量评估-2对研究的偏倚风险进行评估。
共纳入46项研究。AI模型在川崎病中取得了较高的诊断性能,敏感性高达92.5%,特异性高达97.3%。川崎病并发症(如静脉注射免疫球蛋白抵抗)的预测模型曲线下面积在0.716至0.834之间。其他血管炎类型,尤其是那些使用影像数据的类型,研究较少,且常受小数据集限制。
当前文献表明,AI算法可增强血管炎的诊断和预测,深度学习和机器学习模型在川崎病中显示出前景。然而,需要更广泛的数据集、更多的外部验证以及整合大型语言模型等新模型,以提高其在不同血管炎类型中的临床适用性。