@article{3f80babffab34bb7a1cbc501bbf7bcd2,
title = "Artificial intelligence outperforms pulmonologists in the interpretation of pulmonary function tests",
abstract = "The interpretation of pulmonary function tests (PFTs) to diagnose respiratory diseases is built on expert opinion that relies on the recognition of patterns and the clinical context for detection of specific diseases. In this study, we aimed to explore the accuracy and interrater variability of pulmonologists when interpreting PFTs compared with artificial intelligence (AI)-based software that was developed and validated in more than 1500 historical patient cases.120 pulmonologists from 16 European hospitals evaluated 50 cases with PFT and clinical information, resulting in 6000 independent interpretations. The AI software examined the same data. American Thoracic Society/European Respiratory Society guidelines were used as the gold standard for PFT pattern interpretation. The gold standard for diagnosis was derived from clinical history, PFT and all additional tests.The pattern recognition of PFTs by pulmonologists (senior 73%, junior 27%) matched the guidelines in 74.4 +/- 5.9% of the cases (range 56-88%). The interrater variability of kappa=0.67 pointed to a common agreement. Pulmonologists made correct diagnoses in 44.6 +/- 8.7% of the cases (range 24-62%) with a large interrater variability (kappa=0.35). The AI-based software perfectly matched the PFT pattern interpretations (100%) and assigned a correct diagnosis in 82% of all cases (pThe interpretation of PFTs by pulmonologists leads to marked variations and errors. AI-based software provides more accurate interpretations and may serve as a powerful decision support tool to improve clinical practice.",
keywords = "DIAGNOSIS, PERFORMANCE, STRATEGIES, GUIDELINES",
author = "Marko Topalovic and Nilakash Das and Pierre-Regis Burgel and Marc Daenen and Eric Derom and Christel Haenebalcke and Rob Janssen and Kerstjens, {Huib A. M.} and Giuseppe Liistro and Renaud Louis and Vincent Ninane and Christophe Pison and Marc Schlesser and Piet Vercauter and Vogelmeier, {Claus F.} and Emiel Wouters and Jokke Wynants and Wim Janssens and {De Pauw}, R. and C. Depuydt and S. Muyldermans and V. Ringoet and D. Stevens and S. Bayat and J. Benet and E. Catho and J. Claustre and A. Fedi and Ferjani, {M. A.} and R. Guzun and M. Isnard and S. Nicolas and T. Pierret and S. Rouches and B. Wuyam and Corhay, {J. L.} and J. Guiot and {van Veen}, A. and E. Hardeman and F. Pirson and B. Vosse and L. Conemans and M. Maus and M. Bischoff and M. Rutten and D. Agterhuis and R. Sprooten and {Pulm Function Study Investigators}",
note = "Funding Information: Support statement: This work was supported by the Vlaams Agentschap Innoveren & Ondernemen (VLAIO, government body, 2016–2018). The funder had no role in study design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication. Funding information for this article has been deposited with the Crossref Funder Registry. Funding Information: Conflict of interest: M. Topalovic has nothing to disclose. N. Das has nothing to disclose. P-R. Burgel reports personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Novartis, Teva and Vertex, outside the submitted work. M. Daenen has nothing to disclose. E. Derom has nothing to disclose. C. Haenebalcke reports personal fees from Novartis, Chiesi, GSK and AstraZeneca, outside the submitted work. R. Janssen has nothing to disclose. H.A.M. Kerstjens has nothing to disclose. G. Liistro has nothing to disclose. R. Louis reports grants and personal fees from GSK and Novartis, personal fees from AstraZeneca, and grants from Chiesi, outside the submitted work. V. Ninane has nothing to disclose. C. Pison has nothing to disclose. M. Schlesser has nothing to disclose. P. Vercauter has nothing to disclose. C.F. Vogelmeier reports personal fees from Almirall, Cipla, Berlin-Chemie/Menarini, CSL Behring and Teva, grants and personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Grifols, Mundipharma, Novartis and Takeda, grants from German Federal Ministry of Education and Research (BMBF) Competence Network Asthma and COPD (ASCONET), Bayer Schering Pharma AG, MSD and Pfizer, outside the submitted work. E. Wouters reports personal fees for board membership from Nycomed and Boehringer, grants from AstraZeneca and GSK, and personal fees for lectures from AstraZeneca, GSK, Novartis and Chiesi, outside the submitted work. J. Wynants has nothing to disclose. W. Janssens has nothing to disclose. Publisher Copyright: Copyright {\textcopyright} ERS 2019",
year = "2019",
month = apr,
day = "1",
doi = "10.1183/13993003.01660-2018",
language = "English",
volume = "53",
journal = "European Respiratory Journal",
issn = "0903-1936",
publisher = "European Respiratory Society",
number = "4",
}