Zusammenfassung
Big Data und Anwendungen der künstlichen Intelligenz (KI), wie maschinelles Lernen oder Deep Learning, werden die Gesundheitsversorgung zukünftig bereichern und an Bedeutung gewinnen. Sie haben u. a. das Potenzial, unnötige Untersuchungen sowie Diagnose- und Therapiefehler zu vermeiden und eine verbesserte, frühzeitige und beschleunigte Entscheidungsfindung zu ermöglichen. Die Autoren geben in dem Artikel einen Überblick über aktuelle KI-basierte Anwendungen in der Kardiologie. Die Beispiele beschreiben innovative Lösungen zur Risikobewertung, Diagnosestellung und Therapieunterstützung bis hin zum Selbstmanagement der Patienten. Big Data und KI dienen dabei als Basis für eine effiziente, prädiktive, präventive und personalisierte Medizin. Allerdings zeigen die Beispiele auch, dass es weiterer Forschungen bedarf, um die Lösungen im Sinne der Patienten und Ärzteschaft weiter zu entwickeln, die Effektivität und den Nutzen in der Gesundheitsversorgung zu zeigen sowie rechtliche und ethische Standards zu etablieren.
Abstract
Big data and applications of artificial intelligence (AI), such as machine learning or deep learning, will enrich healthcare in the future and become increasingly important. Among other things, they have the potential to avoid unnecessary examinations as well as diagnostic and therapeutic errors. They could enable improved, early and accelerated decision-making. In the article, the authors provide an overview of current AI-based applications in cardiology. The examples describe innovative solutions for risk assessment, diagnosis and therapy support up to patient self-management. Big data and AI serve as a basis for efficient, predictive, preventive and personalised medicine. However, the examples also show that research is needed to further develop the solutions for the benefit of the patient and the medical profession, to demonstrate the effectiveness and benefits in health care and to establish legal and ethical standards.
Notes
Aus Gründen der besseren Lesbarkeit wird auf die gleichzeitige Verwendung männlicher und weiblicher Sprachformen verzichtet. Sämtliche Personenbezeichnungen gelten gleichermaßen für Frauen, Männer und andere Geschlechter.
Literatur
Adedinsewo D, Carter RE, Attia Z, Johnson P, Kashou AH, Dugan JL, Albus M, Sheele JM, Bellolio F, Friedman PA, Lopez-Jimenez F, Noseworthy PA (2020) Artificial Intelligence-Enabled ECG Algorithm to Identify Patients With Left Ventricular Systolic Dysfunction Presenting to the Emergency Department With Dyspnea. Circ Arrhythmia Electrophysiol 13(8):e8437
Andersen RS, Peimankar A, Puthusserypady S (2019) A deep learning approach for real-time detection of atrial fibrillation. Expert Syst Appl 115:465–473
Attia ZI, Kapa S, Lopez-Jimenez F, McKie PM, Ladewig DJ, Satam G, Pellikka PA, Enriquez-Sarano M, Noseworthy PA, Munger TM, Asirvatham SJ, Scott CG, Carter RE, Friedman PA (2019) Screening for cardiac contractile dysfunction using an artificial intelligence–enabled electrocardiogram. Nat Med 25(1):70–74
Braunwald E (2019) Diabetes, heart failure, and renal dysfunction: The vicious circles. Prog Cardiovasc Dis 62(4):298–302
Brunner-La Rocca H‑P, Fleischhacker L, Golubnitschaja O, Heemskerk F, Helms T, Hoedemakers T, Allianses SH, Jaarsma T, Kinkorova J, Ramaekers J, Ruff P, Schnur I, Vanoli E, Verdu J, Zippel-Schultz B (2016) Challenges in personalised management of chronic diseases-heart failure as prominent example to advance the care process. EPMA J 7(1):2–2
Brynjolfsson E, McAfee A (2017) The Business of Artificial Intelligence: what it can and cannot do for your organization. Harv Bus Rev Digit Articles 7(21):1–20
Budde K et al. (2020) KI in der Medizin und. Pflege : (aus der Perspektive Betroffener. Tagungsbericht zum Runden Tisch mit Patientenvertretungen aus der Plattform Lernender Systeme. München). https://www.plattform-lernende-systeme.de/files/Downloads/Publikationen/AG6_Whitepaper_Medizin_Pflege_Tagungsbericht.pdf
Bumgarner JM, Lambert CT, Hussein AA, Cantillon DJ, Baranowski B, Wolski K, Lindsay BD, Wazni OM, Tarakji KG (2018) Smartwatch Algorithm for Automated Detection of Atrial Fibrillation. J Am Coll Cardiol 71(21):2381–2388
Cano Martín JA, Martínez-Pérez B, de la Torre-Díez I, López-Coronado M (2014) Economic Impact Assessment from the Use of a Mobile App for the Self-management of Heart Diseases by Patients with Heart Failure in a Spanish Region. J Med Syst 38(9):96
Cantwell CD, Mohamied Y, Tzortzis KN, Garasto S, Houston C, Chowdhury RA, Ng FS, Bharath AA, Peters NS (2019) Rethinking multiscale cardiac electrophysiology with machine learning and predictive modelling. Comput Biol Med 104:339–351
Capper, D., Jones, D. T. W., Sill, M., Hovestadt, V., Schrimpf, D., Sturm, D., Koelsche, C., Sahm, F., Chavez, L., Reuss, D. E., Kratz, A., Wefers, A. K., Huang, K., Pajtler, K. W., Schweizer, L., Stichel, D., Olar, A., Engel, N. W., Lindenberg, K., …, & Pfister, S. M. 2018. DNA methylation-based classification of central nervous system tumours. Nature, 555(7697): 469–474.
Choi BG, Rha SW, Kim SW, Kang JH, Park JY, Noh YK (2019) Machine Learning for the Prediction of New-Onset Diabetes Mellitus during 5‑Year Follow-up in Non-Diabetic Patients with Cardiovascular Risks. Yonsei Med J 60(2):191–199
Cikes M, Sanchez-Martinez S, Claggett B, Duchateau N, Piella G, Butakoff C, Pouleur AC, Knappe D, Biering-Sørensen T, Kutyifa V, Moss A, Stein K, Solomon SD, Bijnens B, Sanchez-Martinez S, Biering-Sørensen T (2019) Machine learning-based phenogrouping in heart failure to identify responders to cardiac resynchronization therapy. Eur J Heart Fail 21(1):74–85
Clark AM, Wiens KS, Banner D, Kryworuchko J, Thirsk L, McLean L, Currie K (2016) A systematic review of the main mechanisms of heart failure disease management interventions. Heart 102(9):707–711
Coudray N, Ocampo PS, Sakellaropoulos T, Narula N, Snuderl M, Fenyö D, Moreira AL, Razavian N, Tsirigos A (2018) Classification and mutation prediction from non-small cell lung cancer histopathology images using deep learning. Nat Med 24(10):1559–1567
Dengler K, Matthes B (2015) Folgen der Digitalisierung für die Arbeitswelt. Substituierbarkeitspotenziale von Berufen in Deutschland: Institut für Arbeitsmarkt- und Berufsforschung der Bundesagentur für Arbeit. http://doku.iab.de/forschungsbericht/2015/fb1115.pdf
Ehteshami Bejnordi B, Veta M, van Diest JP, van Ginneken B, Karssemeijer N, Litjens G, van der Laak J, Hermsen M, Manson QF, Balkenhol M, Geessink O, Stathonikos N, van Dijk MC, Bult P, Beca F, Beck AH, Wang D, Khosla A, Gargeya R, Irshad H, Zhong A, Dou Q, Li Q, Chen H, Lin HJ, Heng PA, Haß C, Bruni E, Wong Q, Halici U, Öner M, Cetin-Atalay R, Berseth M, Khvatkov V, Vylegzhanin A, Kraus O, Shaban M, Rajpoot N, Awan R, Sirinukunwattana K, Qaiser T, Tsang YW, Tellez D, Annuscheit J, Hufnagl P, Valkonen M, Kartasalo K, Latonen L, Ruusuvuori P, Liimatainen K, Albarqouni S, Mungal B, George A, Demirci S, Navab N, Watanabe S, Seno S, Takenaka Y, Matsuda H, Ahmady Phoulady H, Kovalev V, Kalinovsky A, Liauchuk V, Bueno G, Fernandez-Carrobles MM, Serrano I, Deniz O, Racoceanu D, Venâncio R (2017) Diagnostic Assessment of Deep Learning Algorithms for Detection of Lymph Node Metastases in Women With Breast Cancer. JAMA 318(22):2199–2210
Esteva A, Kuprel B, Novoa RA, Ko J, Swetter SM, Blau HM, Thrun S (2017) Dermatologist-level classification of skin cancer with deep neural networks. Nature 542(7639):115–118
Feldman DI, Robison TW, Pacor JM, Caddell LC, Feldman EB, Deitz RL, Feldman T, Martin SS, Nasir K, Blaha MJ (2018) Harnessing mHealth technologies to increase physical activity and prevent cardiovascular disease. Clin Cardiol 41(7):985–991
Frey CB, Osborne MA (2017) The future of employment: How susceptible are jobs to computerisation? Technol Forecast Soc Change 114:254–280
Galperin, R. V. 2020. Organizational Powers: Contested Innovation and Loss of Professional Jurisdiction in the Case of Retail Medicine. Organization Science, 31(2): 508–534.
Golubnitschaja O, Kinkorova J, Costigliola V (2014) Predictive, preventive and personalised medicine as the hardcore of ‘Horizon 2020’: EPMA position paper. EPMA J 5(1):6
Greenhalgh T, Wherton J, Papoutsi C, Lynch J, Hughes G, A’Court C, Hinder S, Fahy N, Procter R, Shaw S (2017) Beyond Adoption: A New Framework for Theorizing and Evaluating Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies. J Med Internet Res 19(11):e367
Gulshan V, Peng L, Coram M, Stumpe MC, Wu D, Narayanaswamy A, Venugopalan S, Widner K, Madams T, Cuadros J, Kim R, Raman R, Nelson PC, Mega JL, Webster DR (2016) Development and Validation of a Deep Learning Algorithm for Detection of Diabetic Retinopathy in Retinal Fundus Photographs. JAMA 316(22):2402–2410
Haenssle HA, Fink C, Schneiderbauer R, Toberer F, Buhl T, Blum A, Kalloo A, Hassen ABH, Thomas L, Enk A, Uhlmann L, Alt C, Arenbergerova M, Bakos R, Baltzer A, Bertlich I, Blum A, Bokor-Billmann T, Bowling J, Braghiroli N, Braun R, Buder-Bakhaya K, Buhl T, Cabo H, Cabrijan L, Cevic N, Classen A, Deltgen D, Fink C, Georgieva I, Hakim-Meibodi LE, Hanner S, Hartmann F, Hartmann J, Haus G, Hoxha E, Karls R, Koga H, Kreusch J, Lallas A, Majenka P, Marghoob A, Massone C, Mekokishvili L, Mestel D, Meyer V, Neuberger A, Nielsen K, Oliviero M, Pampena R, Paoli J, Pawlik E, Rao B, Rendon A, Russo T, Sadek A, Samhaber K, Schneiderbauer R, Schweizer A, Toberer F, Trennheuser L, Vlahova L, Wald A, Winkler J, Wölbing P, Zalaudek I (2018) Man against machine: diagnostic performance of a deep learning convolutional neural network for dermoscopic melanoma recognition in comparison to 58 dermatologists. Ann Oncol 29(8):1836–1842
Helms T, Duong G, Zippel-Schultz B, Tilz R, Kuck K‑H, Karle C (2014) Prediction and personalised treatment of atrial fibrillation—stroke prevention: consolidated position paper of CVD professionals. Epma J 5(1):15
Hernandez-Suarez DF, Ranka S, Kim Y, Latib A, Wiley J, Lopez-Candales A, Pinto DS, Gonzalez MC, Ramakrishna H, Sanina C, Nieves-Rodriguez BG, Rodriguez-Maldonado J, Feliu Maldonado R, Rodriguez-Ruiz IJ, da Luz Sant’Ana I, Wiley KA, Cox-Alomar P, Villablanca PA, Roche-Lima A (2020) Machine-learning-based in-hospital mortality prediction for transcatheter mitral valve repair in the. Cardiovascular Revascularization Medicine, United States
Krittanawong C, Zhang H, Wang Z, Aydar M, Kitai T (2017) Artificial Intelligence in Precision Cardiovascular Medicine. J Am Coll Cardiol 69(21):2657–2664
Kuck KH, Böcker D, Chun J, Deneke T, Hindricks G, Hoffmann E, Piorkowski C, Willems S (2017) Qualitätskriterien zur Durchführung der Katheterablation von Vorhofflimmern. Kardiologe 11(3):161–182
Liu X, Rivera CS, Moher D, Calvert MJ, Denniston AK, Chan A‑W, Darzi A, Holmes C, Yau C, Ashrafian H, Deeks JJ, Ferrante di Ruffano L, Faes L, Keane PA, Vollmer SJ, Lee AY, Jonas A, Esteva A, Beam AL, Chan A‑W, Panico MB, Lee CS, Haug C, Kelly CJ, Yau C, Mulrow C, Espinoza C, Fletcher J, Paltoo D, Manna E, Price G, Collins GS, Harvey H, Matcham J, Monteiro J, ElZarrad MK, Ferrante di Ruffano L, Oakden-Rayner L, McCradden M, Keane PA, Savage R, Golub R, Sarkar R, Rowley S, The S‑A, Group C‑AW, Spirit AI, Group C‑AS, Spirit AI, Group C‑AC (2020) Reporting guidelines for clinical trial reports for interventions involving artificial intelligence: the CONSORT-AI extension. Nat Med 26(9):1364–1374
McKinney SM, Sieniek M, Godbole V, Godwin J, Antropova N, Ashrafian H, Back T, Chesus M, Corrado GS, Darzi A, Etemadi M, Garcia-Vicente F, Gilbert FJ, Halling-Brown M, Hassabis D, Jansen S, Karthikesalingam A, Kelly CJ, King D, Ledsam JR, Melnick D, Mostofi H, Peng L, Reicher JJ, Romera-Paredes B, Sidebottom R, Suleyman M, Tse D, Young KC, De Fauw J, Shetty S (2020) International evaluation of an AI system for breast cancer screening. Nature 577(7788):89–94
Meyer A, Zverinski D, Pfahringer B, Kempfert J, Kuehne T, Sündermann SH, Stamm C, Hofmann T, Falk V, Eickhoff C (2018) Machine learning for real-time prediction of complications in critical care: a retrospective study. Lancet Respir Med 6(12):905–914
Miller T (2019) Explanation in artificial intelligence: Insights from the social sciences. Artif Intell 267:1–38
Misra J, Saha I (2010) Artificial neural networks in hardware: A survey of two decades of progress. Neurocomputing 74(1):239–255
Quer G, Muse ED, Nikzad N, Topol EJ, Steinhubl SR (2017) Augmenting diagnostic vision with AI. Lancet 390(10091):221
Rank N, Pfahringer B, Kempfert J, Stamm C, Kühne T, Schoenrath F, Falk V, Eickhoff C, Meyer A (2020) Deep-learning-based real-time prediction of acute kidney injury outperforms human predictive performance. Npj Digit Med 3:139
Santo K, Redfern J (2019) The Potential of mHealth Applications in Improving Resistant Hypertension Self-Assessment, Treatment and Control. Curr Hypertens Rep 21(10):81
Schultz C (2009) Collaboration with users of innovative healthcare services—the role of service familiarity. Int J Serv Technol Manag 12(3):338–355
Schwartz, W. B. 1970. Medicine and the computer. The promise and problems of change. N Engl J Med, 283(23): 1257–1264.
Sternkopf, J., & Schultz, C. 2020. Hospitals’ adoption of medical device registers: Evidence from the German Arthroplasty Register. Health Care Manage Rev, 45(1): 3–11.
Sutton RT, Pincock D, Baumgart DC, Sadowski DC, Fedorak RN, Kroeker KI (2020) An overview of clinical decision support systems: benefits, risks, and strategies for success. Npj Digit Med 3(1):17
Tesche C, De Cecco CN, Baumann S, Renker M, McLaurin TW, Duguay TM, Bayer RR 2nd, Steinberg DH, Grant KL, Canstein C, Schwemmer C, Schoebinger M, Itu LM, Rapaka S, Sharma P, Schoepf UJ (2018) Coronary CT Angiography-derived Fractional Flow Reserve: Machine Learning Algorithm versus Computational Fluid Dynamics Modeling. Radiology 288(1):64–72
Ting DSW, Pasquale LR, Peng L, Campbell JP, Lee AY, Raman R, Tan GSW, Schmetterer L, Keane PA, Wong TY (2019) Artificial intelligence and deep learning in ophthalmology. Br J Ophthalmol 103(2):167–175
Topol E (2019) Deep Medicine. How Artificial. Intelligence : (Can Make Healthcare Human Again. New York: Basic Books)
Venkatesh V, Morris MG, Davis GB, Davis FD (2003) User Acceptance of Information Technology: Toward a Unified View. MISQ 27(3):425–478
von Knebel Doeberitz PL, De Cecco CN, Schoepf UJ, Duguay TM, Albrecht MH, van Assen M, Bauer MJ, Savage RH, Pannell JT, De Santis D, Johnson AA, Varga-Szemes A, Bayer RR, Schönberg SO, Nance JW, Tesche C (2019) Coronary CT angiography–derived plaque quantification with artificial intelligence CT fractional flow reserve for the identification of lesion-specific ischemia. Eur Radiol 29(5):2378–2387
Voss R, Cullen P, Schulte H, Assmann G (2002) Prediction of risk of coronary events in middle-aged men in the Prospective Cardiovascular Münster Study (PROCAM) using neural networks. Int J Epidemiol 31(6):1253–1262
Wang P, Xiao X, Glissen Brown JR, Berzin TM, Tu M, Xiong F, Hu X, Liu P, Song Y, Zhang D, Yang X, Li L, He J, Yi X, Liu J, Liu X (2018) Development and validation of a deep-learning algorithm for the detection of polyps during colonoscopy. Nat Biomed Eng 2(10):741–748
Weng SF, Reps J, Kai J, Garibaldi JM, Qureshi N (2017) Can machine-learning improve cardiovascular risk prediction using routine clinical data? PLoS ONE 12(4):e174944
Young, J. B., Abraham, W. T., Smith, A. L., Leon, A. R., Lieberman, R., Wilkoff, B., Canby, R. C., Schroeder, J. S., Liem, L. B., Hall, S., & Wheelan, K. 2003. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. Jama, 289(20): 2685–2694.
Zeevi D, Korem T, Zmora N, Israeli D, Rothschild D, Weinberger A, Ben-Yacov O, Lador D, Avnit-Sagi T, Lotan-Pompan M, Suez J, Mahdi JA, Matot E, Malka G, Kosower N, Rein M, Zilberman-Schapira G, Dohnalová L, Pevsner-Fischer M, Bikovsky R, Halpern Z, Elinav E, Segal E (2015) Personalized Nutrition by Prediction of Glycemic Responses. Cell 163(5):1079–1094
Zellweger MJ, Tsirkin A, Vasilchenko V, Failer M, Dressel A, Kleber ME, Ruff P, März W (2018) A new non-invasive diagnostic tool in coronary artery disease: artificial intelligence as an essential element of predictive, preventive, and personalized medicine. EPMA J 9(3):235–247
Zippel-Schultz B, Schultz C, Helms TM (2017) Aktueller Stand und Zukunft des Telemonitoring. Herzschr Elektrophys 28(3):245–256
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
B. Zippel-Schultz, C. Schultz, D. Müller-Wieland, A.B. Remppis, M. Stockburger, C. Perings und T. M. Helms geben an, dass kein Interessenkonflikt besteht.
Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
Rights and permissions
About this article
Cite this article
Zippel-Schultz, B., Schultz, C., Müller-Wieland, D. et al. Künstliche Intelligenz in der Kardiologie. Herzschr Elektrophys 32, 89–98 (2021). https://doi.org/10.1007/s00399-020-00735-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00399-020-00735-2