Evidence map›Paper›PMID 37261453›Full record

SynthesisClinical neuroradiology2023

Systematic Review of Artificial Intelligence for Abnormality Detection in High-volume Neuroimaging and Subgroup Meta-analysis for Intracranial Hemorrhage Detection.

Siddharth Agarwal, David Wood, Mariusz Grzeda, Chandhini Suresh, Munaib Din, James Cole, Marc Modat, Thomas C Booth

Open access · hybridAbstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Clinical neuroradiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
1.5field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 38 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Siddharth AgarwalSchool of Biomedical Engineering & Imaging Sciences, King's College London, Rayne Institute, 4th Floor, Lambeth Wing, SE1 7EH, London, UK. siddharth.1.agarwal@kcl.ac.uk.ORCID http://orcid.org/0000-0002-6477-6284
David WoodSchool of Biomedical Engineering & Imaging Sciences, King's College London, Rayne Institute, 4th Floor, Lambeth Wing, SE1 7EH, London, UK.
Mariusz GrzedaSchool of Biomedical Engineering & Imaging Sciences, King's College London, Rayne Institute, 4th Floor, Lambeth Wing, SE1 7EH, London, UK.
Chandhini SureshLeicester Medical School, University of Leicester, LE1 7RH, Leicester, UK.
Munaib DinSchool of Biomedical Engineering & Imaging Sciences, King's College London, Rayne Institute, 4th Floor, Lambeth Wing, SE1 7EH, London, UK.
James ColeCentre for Medical Image Computing, Department of Computer Science, University College London, WC1V 6LJ, London, UK.
Marc ModatSchool of Biomedical Engineering & Imaging Sciences, King's College London, Rayne Institute, 4th Floor, Lambeth Wing, SE1 7EH, London, UK.
Thomas C BoothSchool of Biomedical Engineering & Imaging Sciences, King's College London, Rayne Institute, 4th Floor, Lambeth Wing, SE1 7EH, London, UK. thomas.booth@kcl.ac.uk.
King's College London · GBSt Thomas' Hospital · GBUniversity College London · GBUniversity of Leicester · GB

Funding

Medical Research Council MR/W021684/1Wellcome Trust 203148/Z/16/ZWellcome Trust WT 203148/Z/16/Z
6 · The paper itself

Abstract

purposeMost studies evaluating artificial intelligence (AI) models that detect abnormalities in neuroimaging are either tested on unrepresentative patient cohorts or are insufficiently well-validated, leading to poor generalisability to real-world tasks. The aim was to determine the diagnostic test accuracy and summarise the evidence supporting the use of AI models performing first-line, high-volume neuroimaging tasks.

methodsMedline, Embase, Cochrane library and Web of Science were searched until September 2021 for studies that temporally or externally validated AI capable of detecting abnormalities in first-line computed tomography (CT) or magnetic resonance (MR) neuroimaging. A bivariate random effects model was used for meta-analysis where appropriate. This study was registered on PROSPERO as CRD42021269563.

resultsOut of 42,870 records screened, and 5734 potentially eligible full texts, only 16 studies were eligible for inclusion. Included studies were not compromised by unrepresentative datasets or inadequate validation methodology. Direct comparison with radiologists was available in 4/16 studies and 15/16 had a high risk of bias. Meta-analysis was only suitable for intracranial hemorrhage detection in CT imaging (10/16 studies), where AI systems had a pooled sensitivity and specificity 0.90 (95% confidence interval [CI] 0.85-0.94) and 0.90 (95% CI 0.83-0.95), respectively. Other AI studies using CT and MRI detected target conditions other than hemorrhage (2/16), or multiple target conditions (4/16). Only 3/16 studies implemented AI in clinical pathways, either for pre-read triage or as post-read discrepancy identifiers.

conclusionThe paucity of eligible studies reflects that most abnormality detection AI studies were not adequately validated in representative clinical cohorts. The few studies describing how abnormality detection AI could impact patients and clinicians did not explore the full ramifications of clinical implementation.

Indexed as

Artificial IntelligenceMagnetic Resonance ImagingHumansIntracranial HemorrhagesNeuroimagingSensitivity and SpecificityAnomaly detectionBrain MRIClinical validationDeep learningMachine learning

Identifiers

PMID37261453
PMCPMC10233528
OpenAlexW4378952208

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.