Hybrid novice-AI system achieves expert-level performance in intraoperative ischemia detection
Murali, N.; Mina, A. I.; Anderson, J. W.; Raka, Y.; Amiri, H. K.; Thirumala, P. D.; Batmanghelich, K.; Visweswaran, S.
Show abstract
Carotid endarterectomy carries the risk of intraoperative cerebral ischemia, which is monitored by expert neurophysiologists through continuous electroencephalography (cEEG). Because expert availability is limited, we developed a hybrid novice-artificial intelligence (AI) system that detects ischemia using novice monitors with limited cEEG training. The hybrid system dynamically weights novice and AI inputs to arrive at a final output. Using four novices, we compared hybrid systems against experts alone, novices alone, and AI alone. Hybrid systems were statistically non-inferior to experts in sensitivity and false-positive rate (FPR), whereas novices alone were not. At 80% sensitivity, hybrid systems reduced FPR by half compared with the AI-only system, with similar benefits at 90% sensitivity. Further, the area under the precision-recall curve improved from 0.546 to 0.610-0.726, the area under the receiver operating characteristic curve improved from 0.957 to 0.967-0.971, and calibration improved compared with AI alone. These results highlight the potential of a hybrid system to monitor intraoperative cerebral ischemia.
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