{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:21:51Z","timestamp":1788999711845,"version":"build-2803163510"},"reference-count":33,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T00:00:00Z","timestamp":1635984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH-C107-007-007-S02"],"award-info":[{"award-number":["TSGH-C107-007-007-S02"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH-E-110263"],"award-info":[{"award-number":["TSGH-E-110263"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["MOST 108-2314-B-016-001"],"award-info":[{"award-number":["MOST 108-2314-B-016-001"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["MOST 109-2314-B-016-026"],"award-info":[{"award-number":["MOST 109-2314-B-016-026"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["106-2314-B-016-038-MY3"],"award-info":[{"award-number":["106-2314-B-016-038-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Science and Technology Development Fund Management Association, Taiwan","award":["MOST 108-3111-Y-016-009"],"award-info":[{"award-number":["MOST 108-3111-Y-016-009"]}]},{"name":"National Science and Technology Development Fund Management Association, Taiwan","award":["MOST 109-3111-Y-016-002"],"award-info":[{"award-number":["MOST 109-3111-Y-016-002"]}]},{"DOI":"10.13039\/501100005937","name":"Cheng Hsin General Hospital","doi-asserted-by":"publisher","award":["CHNDMC-109-19"],"award-info":[{"award-number":["CHNDMC-109-19"]}],"id":[{"id":"10.13039\/501100005937","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005937","name":"Cheng Hsin General Hospital","doi-asserted-by":"publisher","award":["CHNDMC-110-15"],"award-info":[{"award-number":["CHNDMC-110-15"]}],"id":[{"id":"10.13039\/501100005937","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>(1) Background: While an artificial intelligence (AI)-based, cardiologist-level, deep-learning model for detecting acute myocardial infarction (AMI), based on a 12-lead electrocardiogram (ECG), has been established to have extraordinary capabilities, its real-world performance and clinical applications are currently unknown. (2) Methods and Results: To set up an artificial intelligence-based alarm strategy (AI-S) for detecting AMI, we assembled a strategy development cohort including 25,002 visits from August 2019 to April 2020 and a prospective validation cohort including 14,296 visits from May to August 2020 at an emergency department. The components of AI-S consisted of chest pain symptoms, a 12-lead ECG, and high-sensitivity troponin I. The primary endpoint was to assess the performance of AI-S in the prospective validation cohort by evaluating F-measure, precision, and recall. The secondary endpoint was to evaluate the impact on door-to-balloon (DtoB) time before and after AI-S implementation in STEMI patients treated with primary percutaneous coronary intervention (PPCI). Patients with STEMI were alerted precisely by AI-S (F-measure = 0.932, precision of 93.2%, recall of 93.2%). Strikingly, in comparison with pre-AI-S (N = 57) and post-AI-S (N = 32) implantation in STEMI protocol, the median ECG-to-cardiac catheterization laboratory activation (EtoCCLA) time was significantly reduced from 6.0 (IQR, 5.0\u20138.0 min) to 4.0 min (IQR, 3.0\u20135.0 min) (p &lt; 0.01). The median DtoB time was shortened from 69 (IQR, 61.0\u201382.0 min) to 61 min (IQR, 56.8\u201373.2 min) (p = 0.037). (3) Conclusions: AI-S offers front-line physicians a timely and reliable diagnostic decision-support system, thereby significantly reducing EtoCCLA and DtoB time, and facilitating the PPCI process. Nevertheless, large-scale, multi-institute, prospective, or randomized control studies are necessary to further confirm its real-world performance.<\/jats:p>","DOI":"10.3390\/jpm11111149","type":"journal-article","created":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T22:25:54Z","timestamp":1636064754000},"page":"1149","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["An Artificial Intelligence-Based Alarm Strategy Facilitates Management of Acute Myocardial Infarction"],"prefix":"10.3390","volume":"11","author":[{"given":"Wen-Cheng","family":"Liu","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2337-2096","authenticated-orcid":false,"given":"Chin","family":"Lin","sequence":"additional","affiliation":[{"name":"Medical Technology Education Center, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan"},{"name":"School of Public Health, National Defense Medical Center, Taipei 114, Taiwan"},{"name":"Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5167-8327","authenticated-orcid":false,"given":"Chin-Sheng","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Chien","family":"Tsai","sequence":"additional","affiliation":[{"name":"Graduate Institute of Physiology and Biophysics, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2105-7570","authenticated-orcid":false,"given":"Sy-Jou","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0215-3193","authenticated-orcid":false,"given":"Shih-Hung","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Shiang","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Cheng","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"},{"name":"Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9935-5172","authenticated-orcid":false,"given":"Tien-Ping","family":"Tsao","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"},{"name":"Division of Cardiology, Heart Centre, Cheng Hsin General Hospital, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9614-7389","authenticated-orcid":false,"given":"Cheng-Chung","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC)","volume":"39","author":"Ibanez","year":"2018","journal-title":"Eur. 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