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Title: | Artificial intelligence outperforms pulmonologists in the interpretation of pulmonary function tests | Authors: | Topalovic, Marko Das, Nilakash Burgel, Pierre-Regis DAENEN, Marc Derom, Eric Haenebalcke, Christel Janssen, Rob Kerstjens, Huib A. M. Liistro, Giuseppe Louis, Renaud Ninane, Vincent Pison, Christophe Schlesser, Marc Vercauter, Piet Vogelmeier, Claus F. Wouters, Emiel Wynants, Jokke Janssens, Wim De Pauw, R. Depuydt, C. Haenebalcke, C. Muyldermans, S. Ringoet, V. Stevens, D. Bayat, S. Benet, J. Catho, E. Claustre, J. Fedi, A. Ferjani, M. A. Guzun, R. Isnard, M. Nicolas, S. Pierret, T. Pison, C. Rouches, S. Wuyam, B. Corhay, J. L. Guiot, J. Ghysen, K. Renaud, L. Sibille, A. De La Barriere, H. Charpentier, C. Corhut, S. Hamdan, K. A. Schlesser, M. Wirtz, G. Alabadan, E. Birsen, G. Burgel, P. R. Chohra, A. Hamard, C. Lemarie, B. Lothe, M. N. Martin, C. Sainte-Marie, A. C. Sebane, L. Berk, Y. de Brouwer, B. Kerkhoff, J. Spaanderman, A. Stegers, M. Termeer, A. van Grimbergen, I. van Veen, A. van Ruitenbeek, L. Vermeer, L. Zaal, R. Zijlker, M. AUMANN, Joseph CUPPENS, Kristof Degraeve, D. DEMUYNCK, Koen Dieriks, B. Pat, Kris SPAAS, Luc Van Puijenbroek, R. Weytjens, K. Wynants, J. Adam, V. Berendes, B. J. Hardeman, E. Jordens, P. Munghen, E. Tournoy, K. Vercauter, P. Alame, T. Bruyneel, M. Gabrovska, M. Muylle, I. Ninane, V. Rozen, D. Rummens, P. Van den Broecke, S. Froidure, A. Gohy, S. Liistro, G. Pieters, T. Pilette, C. Pirson, F. Kerstjens, H. Van den Berge, M. Ten Hacken, N. Duiverman, M. Koster, D. Vosse, B. Conemans, L. Maus, M. Bischoff, M. Rutten, M. Agterhuis, D. Sprooten, R. Beutel, B. Jerrentrup, A. Klemmer, A. Viniol, C. Vogelmeier, C. Bode, H. Dooms, C. Gullentops, D. Janssens, Wim Nackaerts, K. Rutens, D. Wauters, E. Wuyts, W. Derom, E. Dobbelaere, S. Loof, S. Serry, G. Putman, B. Van Acker, L. Vandeweygaerde, Y. Criel, M. Daenen, Michaël Gubbelmans, R. Klerkx, S. Michiels, E. THOMEER, Michiel Vanhauwaert, A. |
Issue Date: | 2019 | Publisher: | EUROPEAN RESPIRATORY SOC JOURNALS LTD | Source: | EUROPEAN RESPIRATORY JOURNAL, 53(4), (Art N° 1801660) | Abstract: | The interpretation of pulmonary function tests (PFTs) to diagnose respiratory diseases is built on expert opinion that relies on the recognition of patterns and the clinical context for detection of specific diseases. In this study, we aimed to explore the accuracy and interrater variability of pulmonologists when interpreting PFTs compared with artificial intelligence (AI)-based software that was developed and validated in more than 1500 historical patient cases. 120 pulmonologists from 16 European hospitals evaluated 50 cases with PFT and clinical information, resulting in 6000 independent interpretations. The AI software examined the same data. American Thoracic Society/European Respiratory Society guidelines were used as the gold standard for PFT pattern interpretation. The gold standard for diagnosis was derived from clinical history, PFT and all additional tests. The pattern recognition of PFTs by pulmonologists (senior 73%, junior 27%) matched the guidelines in 74.4 +/- 5.9% of the cases (range 56-88%). The interrater variability of kappa=0.67 pointed to a common agreement. Pulmonologists made correct diagnoses in 44.6 +/- 8.7% of the cases (range 24-62%) with a large interrater variability (kappa=0.35). The AI-based software perfectly matched the PFT pattern interpretations (100%) and assigned a correct diagnosis in 82% of all cases (p<0.0001 for both measures). The interpretation of PFTs by pulmonologists leads to marked variations and errors. AI-based software provides more accurate interpretations and may serve as a powerful decision support tool to improve clinical practice. | Notes: | [Topalovic, Marko; Das, Nilakash; Janssens, Wim] Katholieke Univ Leuven, Chron Dis Metab & Ageing, Univ Hosp Leuven, Resp Med, Herestr 49, B-3000 Leuven, Belgium. [Burgel, Pierre-Regis] Univ Paris 05, Cochin Hosp, AP HP, Sorbonne Paris Cite, Paris, France. [Daenen, Marc] Hosp Oost Limburg, Dept Resp Med, Genk, Belgium. [Derom, Eric] Ghent Univ Hosp, Dept Resp Med, Ghent, Belgium. [Haenebalcke, Christel] Acad Hosp St Jan, Dept Resp Med, Brugge, Belgium. [Janssen, Rob] Canisius Wilhelmina Hosp, Dept Pulm Med, Nijmegen, Netherlands. [Kerstjens, Huib A. M.] Univ Groningen, Univ Med Ctr Groningen, Dept Pulm Med & TB, Groningen, Netherlands. [Liistro, Giuseppe] Catholic Univ Louvain, Clin Univ St Luc, Dept Pneumol, Brussels, Belgium. [Louis, Renaud] Univ Hosp, Dept Resp Med, Liege, Belgium. [Ninane, Vincent] Univ Libre Bruxelles, St Pierre Hosp, Dept Resp Med, Brussels, Belgium. [Pison, Christophe] Univ Grenoble Alpes, CHU Grenoble Alpes, Serv Hosp Univ Pneumol & Physiol, Grenoble, France. [Schlesser, Marc] Ctr Hosp Luxembourg, Dept Pulm Med, Luxembourg, Luxembourg. [Vercauter, Piet] Onze Lieve Vrouw Hosp, Dept Resp Med, Aalst, Belgium. [Vogelmeier, Claus F.] Univ Med Ctr Giessen & Marburg, Dept Med Pulm & Crit Care Med, Marburg, Germany. [Vogelmeier, Claus F.] German Ctr Lung Res DZL, Marburg, Germany. [Wouters, Emiel] Maastricht Univ, Med Ctr, Dept Resp Med, Maastricht, Netherlands. [Wynants, Jokke] Jessa Hosp, Dept Pneumol, Hasselt, Belgium. [De Pauw, R.; Depuydt, C.; Haenebalcke, C.; Muyldermans, S.; Ringoet, V.; Stevens, D.] Acad Hosp St Jan, Brugge, Belgium. [Bayat, S.; Benet, J.; Catho, E.; Claustre, J.; Fedi, A.; Ferjani, M. A.; Guzun, R.; Isnard, M.; Nicolas, S.; Pierret, T.; Pison, C.; Rouches, S.; Wuyam, B.] CHU Grenoble Alpes, Grenoble, France. [Corhay, J. L.; Guiot, J.; Ghysen, K.; Renaud, L.; Sibille, A.] Univ Hosp, Liege, Belgium. [De La Barriere, H.; Charpentier, C.; Corhut, S.; Hamdan, K. A.; Schlesser, M.; Wirtz, G.] Ctr Hosp Luxembourg, Luxembourg, Luxembourg. [Alabadan, E.; Birsen, G.; Burgel, P. R.; Chohra, A.; Hamard, C.; Lemarie, B.; Lothe, M. N.; Martin, C.; Sainte-Marie, A. C.; Sebane, L.] Cochin Hosp, Paris, France. [Berk, Y.; de Brouwer, B.; Janssen, R.; Kerkhoff, J.; Spaanderman, A.; Stegers, M.; Termeer, A.; van Grimbergen, I.; van Veen, A.; van Ruitenbeek, L.; Vermeer, L.; Zaal, R.; Zijlker, M.] Canisius Wilhelmina Hosp, Nijmegen, Netherlands. [Aumann, J.; Cuppens, K.; Degraeve, D.; Demuynck, K.; Dieriks, B.; Pat, K.; Spaas, L.; Van Puijenbroek, R.; Weytjens, K.; Wynants, J.] Jessa Hosp, Hasselt, Belgium. [Adam, V.; Berendes, B. J.; Hardeman, E.; Jordens, P.; Munghen, E.; Tournoy, K.; Vercauter, P.] Onze Lieve Vrouw Hosp, Aalst, Belgium. [Alame, T.; Bruyneel, M.; Gabrovska, M.; Muylle, I.; Ninane, V.; Rozen, D.; Rummens, P.; Van den Broecke, S.] St Pierre Hosp, Brussels, Belgium. [Froidure, A.; Gohy, S.; Liistro, G.; Pieters, T.; Pilette, C.; Pirson, F.] Catholic Univ Louvain, Brussels, Belgium. [Kerstjens, H.; Van den Berge, M.; Ten Hacken, N.; Duiverman, M.; Koster, D.] Univ Med Ctr Groningen, Groningen, Netherlands. [Vosse, B.; Conemans, L.; Maus, M.; Bischoff, M.; Rutten, M.; Agterhuis, D.; Sprooten, R.] Maastricht Univ, Med Ctr, Maastricht, Netherlands. [Beutel, B.; Jerrentrup, A.; Klemmer, A.; Viniol, C.; Vogelmeier, C.] Univ Med Ctr, Marburg, Germany. [Bode, H.; Dooms, C.; Gullentops, D.; Janssens, W.; Nackaerts, K.; Rutens, D.; Wauters, E.; Wuyts, W.] Univ Hosp Leuven, Leuven, Belgium. [Derom, E.; Dobbelaere, S.; Loof, S.; Serry, G.; Putman, B.; Van Acker, L.; Vandeweygaerde, Y.] Ghent Univ Hosp, Ghent, Belgium. [Criel, M.; Daenen, M.; Gubbelmans, R.; Klerkx, S.; Michiels, E.; Thomeer, M.; Vanhauwaert, A.] Hosp Oost Limburg, Genk, Belgium. | Keywords: | Diagnosis;Performance;Strategies;Guidelines | Document URI: | http://hdl.handle.net/1942/28756 | ISSN: | 0903-1936 | e-ISSN: | 1399-3003 | DOI: | 10.1183/13993003.01660-2018 | ISI #: | 000464992000005 | Rights: | ERS 2019 | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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