Human, Take this Patient to the Cath Lab – AI and STEMI Detection
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These researchers developed and trained a deep ensemble artificial intelligence (AI) model to classify ECGs as STEMI versus non-STEMI. The AI performed well in both accuracy and in improving sensitivity.
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Development of Clinically Validated Artificial Intelligence Model for Detecting ST-segment Elevation Myocardial Infarction. Ann Emerg Med. 2024 Jul 25:S0196-0644(24)00327-5. doi: 10.1016/j.annemergmed.2024.06.004. Epub ahead of print. PMID: 39066765.
Where’s Waldo? AI Assisted CXR Interpretation
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This retrospective study assessed the benefit of AI-assisted chest x-ray interpretation for non-radiology residents when compared to radiology residents. Pneumothorax and pulmonary nodule detection, in particular, demonstrated meaningful gains in sensitivity and accuracy for non-radiology providers.
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Nonradiology Health Care Professionals Significantly Benefit From AI Assistance in Emergency-Related Chest Radiography Interpretation. Chest. 2024 Jul;166(1):157-170. doi: 10.1016/j.chest.2024.01.039. Epub 2024 Jan 29. PMID: 38295950; PMCID: PMC11251081.
Medical AI – You Reap What You Sow
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This thoughtful review illustrates how human biases and ethical assumptions impact medical AI models, as outputs are based on the training data ingested, human fine-tuning to optimize responses, and the nature and perspective of prompts used. As such, the authors recommend caution in the application of AI to medical decision making.
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Medical Artificial Intelligence and Human Values. N Engl J Med. 2024 May 30;390(20):1895-1904. doi: 10.1056/NEJMra2214183. PMID: 38810186.
The Future of AI for EM – It’s Kind of Exciting!
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Emergency medicine practice is going to be increasingly influenced by artificial intelligence (AI). This article discusses some of the ways we can expect it to impact our practice.
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The AI Future of Emergency Medicine. Ann Emerg Med. 2024 May 22:S0196-0644(24)00043-X. doi: 10.1016/j.annemergmed.2024.01.031. Online ahead of print. PMID: 38795081
I Already Saw My Labs… Are Patients Using Electronic Portals in the Emergency Department?
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Patients are increasingly accessing electronic health portals during ED encounters, but disparities in portal access exist – male, Black, and non-commercially insured patients show lower rates of usage.
“Healthy” Machine Learning Models Could Reduce Bias
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This medical news article interview highlights the risk of biased data leading to inherently biased medical AI models. The ethics of machine learning in general and approaches to minimize bias are also touched on.
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AI Developers Should Understand the Risks of Deploying Their Clinical Tools, MIT Expert Says. JAMA. 2024 Feb 27;331(8):629-631. doi: 10.1001/jama.2023.22981. PMID: 38324320.
Could Teleconsultation Reduce Pediatric Transfers?
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This retrospective study found that of the 4,446 patients transferred over a 4.5-year period, 1,509 (34%) transfers could have possibly been avoided by utilizing telehealth/teleconsultation, with the most common transfer complaints being abdominal pain, asthma, and cough.Â
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Pediatric Patients Discharged After Transfer to a Pediatric Emergency Department: Opportunities for Telehealth?. Ann Emerg Med. 2024;83(3):208-213. doi:10.1016/j.annemergmed.2023.08.489
Pulse Oximetry’s Color Bias
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In a controlled hypoxemia study, pulse oximetry was falsely elevated in subjects with darker skin pigmentation and low perfusion.
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Low Perfusion and Missed Diagnosis of Hypoxemia by Pulse Oximetry in Darkly Pigmented Skin: A Prospective Study. Anesth Analg. 2024 Mar 1;138(3):552-561. doi: 10.1213/ANE.0000000000006755. Epub 2023 Dec 18. PMID: 38109495.
Pay to Play – Telehealth and Inappropriate Antibiotics
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Using online telemedicine platforms, the authors found that it was appallingly easy to rapidly obtain inappropriate antibiotic prescriptions for symptoms of viral URIs by paying a nominal fee. This highlights the need for increased education and regulations around inappropriate prescribing of antibiotics to safeguard the public and uphold good medical practices.
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Antibiotics on Demand: Advances in Asynchronous Telemedicine Call for Increased Antibiotic Surveillance. Clin Infect Dis. 2024 Feb 17;78(2):308-311. doi: 10.1093/cid/ciad472.
Emergency Medicine Should Embrace Our Technological OverlordsÂ
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This article is a call to action for emergency medicine clinicians to encourage us to embrace the opportunity to leverage digital technologies and shape their implementation within our healthcare system.