An ensemble learning model for detection of pulmonary hypertension using electrocardiogram, chest X-ray, and brain natriuretic peptide.

Aims: Delayed diagnosis of pulmonary hypertension (PH) is a known cause of poor patient prognosis. We aimed to develop an artificial intelligence (AI) model, using ensemble learning method to detect PH using electrocardiography (ECG), chest X-ray (CXR), and brain natriuretic peptide (BNP), facilitating accurate detection and prompting further examinations. Methods and results: We developed a convolutional neural network model using ECG data to predict PH, labelled by ECG from seven institutions. Logistic regression was used for the BNP prediction model. We referenced a CXR deep learning model using ResNet18. Outputs from each of the three models were integrated into a three-layer fully connected multimodal model. Ten cardiologists participated in an interpretation test, detecting PH from patients' ECG, CXR, and BNP data both with and without the ensemble learning model. The area under the receiver operating characteristic curves of the ECG, CXR, BNP, and ensemble learning model were 0.818 [95% confidence interval (CI), 0.808-0.828], 0.823 (95% CI, 0.780-0.866), 0.724 (95% CI, 0.668-0.780), and 0.872 (95% CI, 0.829-0.915). Cardiologists' average accuracy rates were 65.0 ± 4.7% for test without AI model and 74.0 ± 2.7% for test with AI model, a statistically significant improvement ( Conclusion: Our ensemble learning model improved doctors' accuracy in detecting PH from ECG, CXR, and BNP examinations. This suggests that earlier and more accurate PH diagnosis is possible, potentially improving patient prognosis.