{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T14:16:54Z","timestamp":1793888214375,"version":"4.8.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Some artificial intelligence models applied in medical practice require ongoing retraining, introduce unintended racial bias, or have variable performance among different subgroups of patients. We assessed the real-world performance of the artificial intelligence-enhanced electrocardiogram to detect left ventricular systolic dysfunction with respect to multiple patient and electrocardiogram variables to determine the algorithm\u2019s long-term efficacy and potential bias in the absence of retraining.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Electrocardiograms acquired in 2019 at Mayo Clinic in Minnesota, Arizona, and Florida with an echocardiogram performed within 14 days were analyzed (n\u2009=\u200944\u2009986 unique patients). The area under the curve (AUC) was calculated to evaluate performance of the algorithm among age groups, racial and ethnic groups, patient encounter location, electrocardiogram features, and over time. The artificial intelligence-enhanced electrocardiogram to detect left ventricular systolic dysfunction had an AUC of 0.903 for the total cohort. Time series analysis of the model validated its temporal stability. Areas under the curve were similar for all racial and ethnic groups (0.90\u20130.92) with minimal performance difference between sexes. Patients with a \u2018normal sinus rhythm\u2019 electrocardiogram (n\u2009=\u200937\u2009047) exhibited an AUC of 0.91. All other electrocardiogram features had areas under the curve between 0.79 and 0.91, with the lowest performance occurring in the left bundle branch block group (0.79).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The artificial intelligence-enhanced electrocardiogram to detect left ventricular systolic dysfunction is stable over time in the absence of retraining and robust with respect to multiple variables including time, patient race, and electrocardiogram features.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjdh\/ztac028","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T07:48:15Z","timestamp":1652773695000},"page":"238-244","source":"Crossref","is-referenced-by-count":38,"title":["Real-world performance, long-term efficacy, and absence of bias in the artificial intelligence enhanced electrocardiogram to detect left ventricular systolic dysfunction"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8102-3380","authenticated-orcid":false,"given":"David M","family":"Harmon","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Mayo Clinic School of Graduate Medical Education , Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0818-273X","authenticated-orcid":false,"given":"Rickey E","family":"Carter","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic College of Medicine , Jacksonville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6532-9252","authenticated-orcid":false,"given":"Michal","family":"Cohen-Shelly","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Svatikova","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , Scottsdale, AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8629-2029","authenticated-orcid":false,"given":"Demilade A","family":"Adedinsewo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , Jacksonville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4308-0456","authenticated-orcid":false,"given":"Peter A","family":"Noseworthy","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2283-4340","authenticated-orcid":false,"given":"Suraj","family":"Kapa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5788-9734","authenticated-orcid":false,"given":"Francisco","family":"Lopez-Jimenez","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5052-2948","authenticated-orcid":false,"given":"Paul A","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9706-7900","authenticated-orcid":false,"given":"Zachi I","family":"Attia","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine , Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,5,17]]},"reference":[{"key":"2024071515002301200_ztac028-B1","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.1016\/j.jacc.2013.05.019","article-title":"2013 ACCF\/AHA Guideline for the management of heart failure: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines","volume":"62","author":"Yancy","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2024071515002301200_ztac028-B2","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1093\/eurheartj\/ehz550","article-title":"Routinely 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