TY - JOUR
T1 - Screening for peripartum cardiomyopathies using artificial intelligence in Nigeria (SPEC-AI Nigeria)
T2 - Clinical trial rationale and design
AU - Adedinsewo, Demilade A.
AU - Morales-Lara, Andrea Carolina
AU - Dugan, Jennifer
AU - Garzon-Siatoya, Wendy T.
AU - Yao, Xiaoxi
AU - Johnson, Patrick W.
AU - Douglass, Erika J.
AU - Attia, Zachi I.
AU - Phillips, Sabrina D.
AU - Yamani, Mohamad H.
AU - Tobah, Yvonne Butler
AU - Rose, Carl H.
AU - Sharpe, Emily E.
AU - Lopez-Jimenez, Francisco
AU - Friedman, Paul A.
AU - Noseworthy, Peter A.
AU - Carter, Rickey E.
N1 - Funding Information:
Research grant support from the Mayo Clinic Center for Digital Health and the Mayo Clinic Center for Community Health Engagement Research. This study was supported in part by the Mayo Clinic Women's Health Research Center and the Mayo Clinic Building Interdisciplinary Research Careers in Women's Health (BIRCWH) Program funded by the National Institutes of Health [grant number K12 HD065987 ]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/7
Y1 - 2023/7
N2 - Background: Artificial intelligence (AI), and more specifically deep learning, models have demonstrated the potential to augment physician diagnostic capabilities and improve cardiovascular health if incorporated into routine clinical practice. However, many of these tools are yet to be evaluated prospectively in the setting of a rigorous clinical trial–a critical step prior to implementing broadly in routine clinical practice. Objectives: To describe the rationale and design of a proposed clinical trial aimed at evaluating an AI-enabled electrocardiogram (AI-ECG) for cardiomyopathy detection in an obstetric population in Nigeria. Design: The protocol will enroll 1,000 pregnant and postpartum women who reside in Nigeria in a prospective randomized clinical trial. Nigeria has the highest reported incidence of peripartum cardiomyopathy worldwide. Women aged 18 and older, seen for routine obstetric care at 6 sites (2 Northern and 4 Southern) in Nigeria will be included. Participants will be randomized to the study intervention or control arm in a 1:1 fashion. This study aims to enroll participants representative of the general obstetric population at each site. The primary outcome is a new diagnosis of cardiomyopathy, defined as left ventricular ejection fraction (LVEF) < 50% during pregnancy or within 12 months postpartum. Secondary outcomes will include the detection of impaired left ventricular function (at different LVEF cut-offs), and exploratory outcomes will include the effectiveness of AI-ECG tools for cardiomyopathy detection, new diagnosis of cardiovascular disease, and the development of composite adverse maternal cardiovascular outcomes. This clinical trial focuses on the emerging field of cardio-obstetrics and will serve as foundational data for the use of AI-ECG tools in an obstetric population in Nigeria. This study will gather essential data regarding the utility of the AI-ECG for cardiomyopathy detection in a predominantly Black population of women and pave the way for clinical implementation of these models in routine practice. Trial registration: Clinicaltrials.gov: NCT05438576.
AB - Background: Artificial intelligence (AI), and more specifically deep learning, models have demonstrated the potential to augment physician diagnostic capabilities and improve cardiovascular health if incorporated into routine clinical practice. However, many of these tools are yet to be evaluated prospectively in the setting of a rigorous clinical trial–a critical step prior to implementing broadly in routine clinical practice. Objectives: To describe the rationale and design of a proposed clinical trial aimed at evaluating an AI-enabled electrocardiogram (AI-ECG) for cardiomyopathy detection in an obstetric population in Nigeria. Design: The protocol will enroll 1,000 pregnant and postpartum women who reside in Nigeria in a prospective randomized clinical trial. Nigeria has the highest reported incidence of peripartum cardiomyopathy worldwide. Women aged 18 and older, seen for routine obstetric care at 6 sites (2 Northern and 4 Southern) in Nigeria will be included. Participants will be randomized to the study intervention or control arm in a 1:1 fashion. This study aims to enroll participants representative of the general obstetric population at each site. The primary outcome is a new diagnosis of cardiomyopathy, defined as left ventricular ejection fraction (LVEF) < 50% during pregnancy or within 12 months postpartum. Secondary outcomes will include the detection of impaired left ventricular function (at different LVEF cut-offs), and exploratory outcomes will include the effectiveness of AI-ECG tools for cardiomyopathy detection, new diagnosis of cardiovascular disease, and the development of composite adverse maternal cardiovascular outcomes. This clinical trial focuses on the emerging field of cardio-obstetrics and will serve as foundational data for the use of AI-ECG tools in an obstetric population in Nigeria. This study will gather essential data regarding the utility of the AI-ECG for cardiomyopathy detection in a predominantly Black population of women and pave the way for clinical implementation of these models in routine practice. Trial registration: Clinicaltrials.gov: NCT05438576.
KW - Artificial intelligence
KW - Cardiomyopathies
KW - Clinical trial
KW - Electrocardiogram
KW - Heart Failure
KW - Nigeria
KW - Peripartum Period
KW - Pregnancy
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U2 - 10.1016/j.ahj.2023.03.008
DO - 10.1016/j.ahj.2023.03.008
M3 - Article
C2 - 36966922
AN - SCOPUS:85152942962
SN - 0002-8703
VL - 261
SP - 64
EP - 74
JO - American Heart Journal
JF - American Heart Journal
ER -