Evidence map›Paper›PMID 39047001›Full record

ArticlePLOS global public health2024

Artificial Intelligence-based automated CT brain interpretation to accelerate treatment for acute stroke in rural India: An interrupted time series study.

Justy Antony Chiramal, Jacob Johnson, Jemin Webster, D Rachel Nag, Dennis Robert, Tamaghna Ghosh, Satish Golla, Saniya Pawar, Pranav Krishnan, Paul K Drain and 1 more

Abstract read
In one paragraph

Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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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

11 authors.

Justy Antony ChiramalDepartment of Epidemiology, University of Washington School of Public Health, Seattle, Washington, United States of America.ORCID https://orcid.org/0000-0002-4538-4445
Jacob JohnsonDepartment of Medicine, Baptist Christian Hospital, Mission Chariali, Tezpur, Assam, India.
Jemin WebsterDepartment of Medicine, Baptist Christian Hospital, Mission Chariali, Tezpur, Assam, India.ORCID https://orcid.org/0000-0002-2506-7135
D Rachel NagDepartment of Medicine, Baptist Christian Hospital, Mission Chariali, Tezpur, Assam, India.
Dennis RobertQure.ai Technologies Pvt. Ltd. Raheja Platinum, Andheri East, Mumbai, India.ORCID https://orcid.org/0000-0002-8539-6408
Tamaghna GhoshQure.ai Technologies Pvt. Ltd. Raheja Platinum, Andheri East, Mumbai, India.
Satish GollaQure.ai Technologies Pvt. Ltd. Raheja Platinum, Andheri East, Mumbai, India.
Saniya PawarQure.ai Technologies Pvt. Ltd. Raheja Platinum, Andheri East, Mumbai, India.
Pranav KrishnanQure.ai Technologies Pvt. Ltd. Raheja Platinum, Andheri East, Mumbai, India.
Paul K DrainDepartment of Epidemiology, University of Washington School of Public Health, Seattle, Washington, United States of America.ORCID https://orcid.org/0000-0002-9569-4097
Stephen J MooneyDepartment of Epidemiology, University of Washington School of Public Health, Seattle, Washington, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In resource-limited settings, timely treatment of acute stroke is dependent upon accurate diagnosis that draws on non-contrast computed tomography (NCCT) scans of the head. Artificial Intelligence (AI) based devices may be able to assist non-specialist physicians in NCCT interpretation, thereby enabling faster interventions for acute stroke patients in these settings. We evaluated the impact of an AI device by comparing the time to intervention (TTI) from NCCT imaging to significant intervention before (baseline) and after the deployment of AI, in patients diagnosed with stroke (ischemic or hemorrhagic) through a retrospective interrupted time series analysis at a rural hospital managed by non-specialists in India. Significant intervention was defined as thrombolysis or antiplatelet therapy in ischemic strokes, and mannitol for hemorrhagic strokes or mass effect. We also evaluated the diagnostic accuracy of the software using the teleradiologists' reports as ground truth. Impact analysis in a total of 174 stroke patients (72 in baseline and 102 after deployment) demonstrated a significant reduction of median TTI from 80 minutes (IQR: 56·8-139·5) during baseline to 58·50 (IQR: 30·3-118.2) minutes after AI deployment (Wilcoxon rank sum test-location shift: -21·0, 95% CI: -38·0, -7·0). Diagnostic accuracy evaluation in a total of 864 NCCT scans demonstrated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) in detecting intracranial hemorrhage to be 0·89 (95% CI: 0·83-0·93), 0·99 (0·98-1·00), 0·96 (0·91-0·98) and 0·97 (0·96-0·98) respectively, and for infarct these were 0·84 (0·79-0·89), 0·81 (0·77-0·84), 0·58 (0·52-0·63), and 0·94 (0·92-0·96), respectively. AI-based NCCT interpretation supported faster abnormality detection with high accuracy, resulting in persons with acute stroke receiving significantly earlier treatment. Our results suggest that AI-based NCCT interpretation can potentially improve uptake of lifesaving interventions for acute stroke in resource-limited settings.

Identifiers

PMID39047001
PMCPMC11268585

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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.