Developing an AI-based decision engine for disease-modifying therapy in heart failure – A pilot study

Arno J Gingele, Hesam Amin, Kurt De Wit, Malte Jacobsen, Arjan Hageman, Kay van der Mierden, Julia Brandts, Jerremy Weerts, Matthew Barrett, Lana J Dixon, Loreena Hill, Christian Knackstedt, Hans-Peter Brunner-La Rocca

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Aims
Heart failure is an escalating burden on global health care systems. Modernizing heart failure care is inevitable, with eHealth products poised to play an important role. However, eHealth devices that can initiate and adjust heart failure medication are currently lacking. Consequently, this study aimed to develop an artificial intelligence-based decision engine to provide guideline-based recommendations for disease-modifying medication in heart failure patients.

Methods and Results
We developed the decision engine by converting the ESC heart failure guidelines into Business Process Model and Notation, a visual modeling language suitable for developing complex decision engines. A safety evaluation, based on clinical parameters, was conducted to ascertain the system’s applicability to specific cases. The decision engine renders specific decisions concerning disease- modifying therapy for heart failure patients. We defined 72 virtual heart failure patient scenarios, encompassing a broad spectrum of baseline characteristics and background medication. All recommendations offered by the engine were evaluated by an independent heart failure specialist. All but three recommendations (94%) were identical to the treatment decisions by the heart failure specialist and all (100%) were in line with the 2021 ESC heart failure guidelines.

Conclusion
The decision engine offers guideline-based recommendations for disease-modifying therapy, positioning it as a tool to enhance self-care among heart failure patients. To validate our results, the decision engine is being prospectively tested in real-world patients in a multicenter clinical trial (NCT04699253).
Original languageEnglish
Pages (from-to)285-288
Number of pages4
JournalEuropean Heart Journal - Digital Health
Early online date1 Dec 2023
DOIs
Publication statusPublished online - 1 Dec 2023

Data Access Statement

The data underlying this article will be shared upon reasonable request to the corresponding author.

Keywords

  • Heart failure
  • Artificial intelligence
  • Decision support systems
  • Clinical
  • Guideline

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