skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Attention:

The NSF Public Access Repository (PAR) system and access will be unavailable from 10:00 PM to 12:00 PM ET on Tuesday, March 25 due to maintenance. We apologize for the inconvenience.


Title: An artificial intelligence system for predicting the deterioration of COVID-19 patients in the emergency department
Abstract During the coronavirus disease 2019 (COVID-19) pandemic, rapid and accurate triage of patients at the emergency department is critical to inform decision-making. We propose a data-driven approach for automatic prediction of deterioration risk using a deep neural network that learns from chest X-ray images and a gradient boosting model that learns from routine clinical variables. Our AI prognosis system, trained using data from 3661 patients, achieves an area under the receiver operating characteristic curve (AUC) of 0.786 (95% CI: 0.745–0.830) when predicting deterioration within 96 hours. The deep neural network extracts informative areas of chest X-ray images to assist clinicians in interpreting the predictions and performs comparably to two radiologists in a reader study. In order to verify performance in a real clinical setting, we silently deployed a preliminary version of the deep neural network at New York University Langone Health during the first wave of the pandemic, which produced accurate predictions in real-time. In summary, our findings demonstrate the potential of the proposed system for assisting front-line physicians in the triage of COVID-19 patients.  more » « less
Award ID(s):
1922658 1940097
PAR ID:
10227681
Author(s) / Creator(s):
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ;
Publisher / Repository:
Nature Publishing Group
Date Published:
Journal Name:
npj Digital Medicine
Volume:
4
Issue:
1
ISSN:
2398-6352
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. null (Ed.)
    Coronavirus Disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-2). The virus transmits rapidly; it has a basic reproductive number (R0) of 2.2-2.7. In March 2020, the World Health Organization declared the COVID-19 outbreak a pandemic. COVID-19 is currently affecting more than 200 countries with 6M active cases. An effective testing strategy for COVID-19 is crucial to controlling the outbreak but the demand for testing surpasses the availability of test kits that use Reverse Transcription Polymerase Chain Reaction (RT-PCR). In this paper, we present a technique to screen for COVID-19 using artificial intelligence. Our technique takes only seconds to screen for the presence of the virus in a patient. We collected a dataset of chest X-ray images and trained several popular deep convolution neural network-based models (VGG, MobileNet, Xception, DenseNet, InceptionResNet) to classify the chest X-rays. Unsatisfied with these models, we then designed and built a Residual Attention Network that was able to screen COVID-19 with a testing accuracy of 98% and a validation accuracy of 100%. A feature maps visual of our model show areas in a chest X-ray which are important for classification. Our work can help to increase the adaptation of AI-assisted applications in clinical practice. The code and dataset used in this project are available at https://github.com/vishalshar/covid-19-screening-using-RAN-on-X-ray-images. 
    more » « less
  2. Calderaro, Adriana (Ed.)
    The World Health Organization (WHO) declared coronavirus disease-2019 (COVID-19) a global pandemic on 11 March 2020. In Ecuador, the first case of COVID-19 was recorded on 29 February 2020. Despite efforts to control its spread, SARS-CoV-2 overran the Ecuadorian public health system, which became one of the most affected in Latin America on 24 April 2020. The Hospital General del Sur de Quito (HGSQ) had to transition from a general to a specific COVID-19 health center in a short period of time to fulfill the health demand from patients with respiratory afflictions. Here, we summarized the implementations applied in the HGSQ to become a COVID-19 exclusive hospital, including the rearrangement of hospital rooms and a triage strategy based on a severity score calculated through an artificial intelligence (AI)-assisted chest computed tomography (CT). Moreover, we present clinical, epidemiological, and laboratory data from 75 laboratory tested COVID-19 patients, which represent the first outbreak of Quito city. The majority of patients were male with a median age of 50 years. We found differences in laboratory parameters between intensive care unit (ICU) and non-ICU cases considering C-reactive protein, lactate dehydrogenase, and lymphocytes. Sensitivity and specificity of the AI-assisted chest CT were 21.4% and 66.7%, respectively, when considering a score >70%; regardless, this system became a cornerstone of hospital triage due to the lack of RT-PCR testing and timely results. If health workers act as vectors of SARS-CoV-2 at their domiciles, they can seed outbreaks that might put 1,879,047 people at risk of infection within 15 km around the hospital. Despite our limited sample size, the information presented can be used as a local example that might aid future responses in low and middle-income countries facing respiratory transmitted epidemics. 
    more » « less
  3. With the spread of COVID-19, significantly more patients have required medical diagnosis to determine whether they are a carrier of the virus. COVID-19 can lead to the development of pneumonia in the lungs, which can be captured in X-Ray and CT scans of the patient's chest. The abundance of X-Ray and CT image data available can be used to develop a high-performing computer vision model able to identify and classify instances of pneumonia present in medical scans. Predictions made by these deep learning models can increase the confidence of diagnoses made by analyzing minute features present in scans exhibiting COVID-19 pneumonia, often unnoticeable to the human eye. Furthermore, rather than teaching clinicians about the mathematics behind deep learning and heat maps, we introduce novel methods of explainable artificial intelligence (XAI) with the goal to annotate instances of pneumonia in medical scans exactly as radiologists do to inform other radiologists, clinicians, and interns about patterns and findings. This project explores methods to train and optimize state-of-the-art deep learning models on COVID-19 pneumonia medical scans and apply explainability algorithms to generate annotated explanations of model predictions that are useful to clinicians and radiologists in analyzing these images. 
    more » « less
  4. Due to the essential role of dentists in stopping the COVID-19 pandemic, the purpose of this review is to help dentists to detect any weaknesses in their disinfection and cross-contamination prevention protocols, and to triage dental treatments to meet the needs of patients during the pandemic. We used PRISMA to identify peer-reviewed publications which supplemented guidance from the center for disease control about infection control and guidelines for dentists. Dentists must triage dental treatments to meet the needs of patients during the pandemic. The ongoing pandemic has changed the practice of dentistry forever, the changes make it more cumbersome, time-consuming, and costly due to the possible pathways of transmission and mitigation steps needed to prevent the spread of COVID-19. Dental chairside rapid tests for SARS-CoV-2 are urgently needed. Until then, dentists need to screen patients for COVID-19 even though 75% of people with COVID-19 have no symptoms. Despite the widespread anxiety and fear of the devastating health effects of COVID-19, only 61% of dentists have implemented a change to their treatment protocols. As an urgent matter of public health, all dentists must identify the additional steps they can take to prevent the spread of COVID-19. The most effective steps to stop the pandemic in dental offices are to; vaccinate all dentists, staff, and patients; triage dental treatments for patients, separate vulnerable patients, separate COVID-19 patients, prevent cross-contamination, disinfect areas touched by patients, maintain social distancing, and change personal protective equipment between patients. 
    more » « less
  5. null (Ed.)
    The new coronavirus (now named SARS-CoV-2) causing the disease pandemic in 2019 (COVID-19), has so far infected over 35 million people worldwide and killed more than 1 million. Most people with COVID-19 have no symptoms or only mild symptoms. But some become seriously ill and need hospitalization. The sickest are admitted to an Intensive Care Unit (ICU) and may need mechanical ventilation to help them breath. Being able to predict which patients with COVID-19 will become severely ill could help hospitals around the world manage the huge influx of patients caused by the pandemic and save lives. Now, Hao, Sotudian, Wang, Xu et al. show that computer models using artificial intelligence technology can help predict which COVID-19 patients will be hospitalized, admitted to the ICU, or need mechanical ventilation. Using data of 2,566 COVID-19 patients from five Massachusetts hospitals, Hao et al. created three separate models that can predict hospitalization, ICU admission, and the need for mechanical ventilation with more than 86% accuracy, based on patient characteristics, clinical symptoms, laboratory results and chest x-rays. Hao et al. found that the patients’ vital signs, age, obesity, difficulty breathing, and underlying diseases like diabetes, were the strongest predictors of the need for hospitalization. Being male, having diabetes, cloudy chest x-rays, and certain laboratory results were the most important risk factors for intensive care treatment and mechanical ventilation. Laboratory results suggesting tissue damage, severe inflammation or oxygen deprivation in the body's tissues were important warning signs of severe disease. The results provide a more detailed picture of the patients who are likely to suffer from severe forms of COVID-19. Using the predictive models may help physicians identify patients who appear okay but need closer monitoring and more aggressive treatment. The models may also help policy makers decide who needs workplace accommodations such as being allowed to work from home, which individuals may benefit from more frequent testing, and who should be prioritized for vaccination when a vaccine becomes available. 
    more » « less