Esther Puyol-Antón, Bram Ruijsink, Baldeep S. Sidhu et al.
Left ventricular (LV) function is an important factor in terms of patient management, outcome, and long-term survival of patients with heart disease. The most recently published clinical guidelines for heart failure recognise that over reliance on only one measure of cardiac function (LV ejection fraction) as a diagnostic and treatment stratification biomarker is suboptimal. Recent advances in AI-based echocardiography analysis have shown excellent results on automated estimation of LV volumes and LV ejection fraction. However, from time-varying 2-D echocardiography acquisition, a richer description of cardiac function can be obtained by estimating functional biomarkers from the complete cardiac cycle. In this work we propose for the first time an AI approach for deriving advanced biomarkers of systolic and diastolic LV function from 2-D echocardiography based on segmentations of the full cardiac cycle. These biomarkers will allow clinicians to obtain a much richer picture of the heart in health and disease. The AI model is based on the 'nn-Unet' framework and was trained and tested using four different databases. Results show excellent agreement between manual and automated analysis and showcase the potential of the advanced systolic and diastolic biomarkers for patient stratification. Finally, for a subset of 50 cases, we perform a correlation analysis between clinical biomarkers derived from echocardiography and CMR and we show excellent agreement between the two modalities.
Aliya Amirova, Theodora Fteropoulli, Nafiso Ahmed et al.
Today, using Large-scale generative Language Models (LLMs) it is possible to simulate free responses to interview questions like those traditionally analyzed using qualitative research methods. Qualitative methodology encompasses a broad family of techniques involving manual analysis of open-ended interviews or conversations conducted freely in natural language. Here we consider whether artificial "silicon participants" generated by LLMs may be productively studied using qualitative methods aiming to produce insights that could generalize to real human populations. The key concept in our analysis is algorithmic fidelity, a term introduced by Argyle et al. (2023) capturing the degree to which LLM-generated outputs mirror human sub-populations' beliefs and attitudes. By definition, high algorithmic fidelity suggests latent beliefs elicited from LLMs may generalize to real humans, whereas low algorithmic fidelity renders such research invalid. Here we used an LLM to generate interviews with silicon participants matching specific demographic characteristics one-for-one with a set of human participants. Using framework-based qualitative analysis, we showed the key themes obtained from both human and silicon participants were strikingly similar. However, when we analyzed the structure and tone of the interviews we found even more striking differences. We also found evidence of the hyper-accuracy distortion described by Aher et al. (2023). We conclude that the LLM we tested (GPT-3.5) does not have sufficient algorithmic fidelity to expect research on it to generalize to human populations. However, the rapid pace of LLM research makes it plausible this could change in the future. Thus we stress the need to establish epistemic norms now around how to assess validity of LLM-based qualitative research, especially concerning the need to ensure representation of heterogeneous lived experiences.