Heart failure with preserved ejection fraction accounts for 50% of all heart failure cases in the UK.
A King’s College London (KCL)-led study has found that the use of artificial intelligence (AI) means black patients are less likely to be diagnosed with common types of heart failure compared to usual care.
The British Heart Foundation-funded study may help researchers understand the extent of under-diagnosis of heart failure with preserved ejection fraction (HFpEF) among ethnic groups, and may help reduce stigma and improve diagnosis.
It is estimated that more than one million people in the UK are living with heart failure, 50% of whom have HFpEF – a condition in which the heart pumps normally but does not fill with blood adequately, causing signs and symptoms of heart failure such as shortness of breath, fatigue and dizziness.
Using an AI algorithm called natural language processing (NLP), which reads and understands medical documents and analyzes electronic medical records, the researchers identified approximately 1,973 patients who met current European Society of Cardiology guidelines for diagnosing HFpEF, of whom 64% were white, 29% were black, and 7% were Asian.
The researchers aimed to explore whether the same patients would be effectively diagnosed in routine practice without NLP, and found that black and Asian patients were less likely to be underdiagnosed when using AI.
The team believes this is because the diagnosis of HFpEF is based in part on the score of the H2FPEF test, which is not used in the algorithm, whereas NLP takes into account other possible factors, such as the fact that hypertension is more prevalent in black patients, whereas atrial fibrillation is more prevalent in whites and Asians.
Ultimately, the researchers believe that HFpEF diagnostic tools may be missing even more Black patients, highlighting the need to improve the diagnosis of HPpEF while analyzing the use of AI to yield more accurate diagnoses.
Study co-leader Dr Kevin O’Gallagher, clinical scientist and honorary consultant in interventional cardiology at KCL, commented: “To effectively tackle inequalities in heart failure, it is vital that clinicians are aware of how heart failure presents in patients of all ethnicities.”
“Further research is needed to improve diagnostic tools. It is important that everyone has the same opportunity to receive quality-of-life improving treatment when they need it most.”
