Artificial Intelligence-Assisted Echocardiographic Image-Analysis for the Diagnosis of Fetal Congenital Heart Disease: A Systematic Review and Meta-Analysis.

BACKGROUND

To assess the precision of artificial intelligence (AI) in aiding the diagnostic process of congenital heart disease (CHD).

METHODS

PubMed, Embase, Cochrane, and Web of Science databases were searched for clinical studies published in English up to March 2024. Studies using AI-assisted ultrasound for diagnosing CHD were included. To evaluate the quality of the studies included in the analysis, the Quality Assessment Tool for Diagnostic Accuracy Studies-2 scale was employed. The overall accuracy of AI-assisted imaging in the diagnosis of CHD was determined using Stata15.0 software. Subgroup analyses were conducted based on region and model architecture.

RESULTS

The analysis encompassed a total of 7 studies, yielding 19 datasets. The combined sensitivity was 0.93 (95% confidence interval (CI): 0.88-0.96), and the specificity was 0.93 (95% CI: 0.88-0.96). The positive likelihood ratio was calculated as 13.0 (95% CI: 7.7-21.9), and the negative likelihood ratio was 0.08 (95% CI: 0.04-0.13). The diagnostic odds ratio was 171 (95% CI: 62-472). The summary receiver operating characteristic (SROC) curve analysis revealed an area under the curve of 0.98 (95% CI: 0.96-0.99). Subgroup analysis found that the ResNet and DenNet architecture models had better diagnostic performance than other models.

CONCLUSIONS

AI demonstrates considerable value in aiding the diagnostic process of CHD. However, further prospective studies are required to establish its utility in real-world clinical practice.

THE PROSPERO REGISTRATION

CRD42024540525, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=540525.