Development of an artificial intelligence-based multimodal model for assisting in the diagnosis of necrotizing enterocolitis in newborns: a retrospective study

Kaijie Cui, Changrong Shao, Maomin Yu, Zhang Hui, Xiuxiang Liu
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Abstract

The purpose of this study is to develop a multimodal model based on artificial intelligence to assist clinical doctors in the early diagnosis of necrotizing enterocolitis in newborns.This study is a retrospective study that collected the initial laboratory test results and abdominal x-ray image data of newborns (non-NEC, NEC) admitted to our hospital from January 2022 to January 2024.A multimodal model was developed to differentiate multimodal data, trained on the training dataset, and evaluated on the validation dataset. The interpretability was enhanced by incorporating the Gradient-weighted Class Activation Mapping (GradCAM) analysis to analyze the attention mechanism of the multimodal model, and finally compared and evaluated with clinical doctors on external datasets.The dataset constructed in this study included 11,016 laboratory examination data from 408 children and 408 image data. When applied to the validation dataset, the area under the curve was 0.91, and the accuracy was 0.94. The GradCAM analysis shows that the model's attention is focused on the fixed dilatation of the intestinal folds, intestinal wall edema, interintestinal gas, and portal venous gas. External validation demonstrated that the multimodal model had comparable accuracy to pediatric doctors with ten years of clinical experience in identification.The multimodal model we developed can assist doctors in early and accurate diagnosis of NEC, providing a new approach for assisting diagnosis in underdeveloped medical areas.
基于人工智能的新生儿坏死性小肠结肠炎多模式辅助诊断模型的开发:一项回顾性研究
本研究是一项回顾性研究,收集了我院2022年1月至2024年1月期间收治的新生儿(非NEC,NEC)的初始实验室检查结果和腹部X光图像数据,并开发了一个多模态模型来区分多模态数据,在训练数据集上进行了训练,并在验证数据集上进行了评估。通过结合梯度加权类激活图谱(GradCAM)分析来分析多模态模型的注意机制,增强了可解释性,最后在外部数据集上与临床医生进行了比较和评估。应用于验证数据集时,曲线下面积为 0.91,准确率为 0.94。GradCAM 分析表明,该模型的注意力集中在肠皱襞固定扩张、肠壁水肿、肠间气体和门静脉气体上。外部验证表明,多模态模型的准确性与具有十年临床经验的儿科医生的鉴定结果相当。我们开发的多模态模型可以帮助医生早期准确诊断 NEC,为医疗欠发达地区的辅助诊断提供了一种新方法。
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