FELIPE MENEGUITTI DIAS

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/65, Hospital das Clínicas, Faculdade de Medicina

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  • article 0 Citação(ões) na Scopus
    Artificial Intelligence-Driven Screening System for Rapid Image-Based Classification of 12-Lead ECG Exams: A Promising Solution for Emergency Room Prioritization
    (2023) DIAS, Felipe Meneguitti; RIBEIRO, Estela; MORENO, Ramon Alfredo; RIBEIRO, Adele Helena; SAMESIMA, Nelson; PASTORE, Carlos Alberto; KRIEGER, Jose Eduardo; GUTIERREZ, Marco Antonio
    The electrocardiogram (ECG) serves as a valuable diagnostic tool, providing crucial information about life-threatening cardiac conditions such as atrial fibrillation and myocardial infarction. A prompt and efficient assessment of ECG exams in environments such as Emergency Rooms (ERs) can significantly enhance the chances of survival for high-risk patients. Despite the presence of numerous works on ECG classification, most of these studies have concentrated on one-dimensional ECG signals, which are commonly found in publicly available ECG datasets. Nevertheless, the practical relevance of such methods is limited in hospital settings, where ECG exams are usually stored as images. In this study, we have developed an artificial intelligence-driven screening system specifically designed to analyze 12-lead ECG images. Our proposed method has been trained on an extensive dataset comprising 99,746 12-lead ECG exams collected from the ambulatory section of a tertiary hospital. The primary goal was to precisely classify the exams into three classes: Normal (N), Atrial Fibrillation (AFib), and Other (O). The evaluation of our approach yielded AUROC scores of 93.2%, 99.2%, and 93.1% for N, AFib, and O, respectively. To further validate our approach, we conducted evaluations using the 2018 China Physiological Signal Challenge (CPSC) database. In this evaluation, we achieved AUROC scores of 91.8%, 97.5%, and 70.4% for the classes N, AFib, and O, respectively. Additionally, we assessed our method using 1,074 exams acquired in the ER and obtained AUROC values of 98.3%, 98.0%, and 97.7% for the classes N, AFib, and O, respectively. Furthermore, we developed and deployed a system with a trained model within the ER of a tertiary hospital for research purposes. This system automatically retrieves newly captured ECG chart images from the Picture Archiving and Communication System (PACS) within the ER. These images undergo necessary preprocessing steps and serve as input for our proposed classification method. This comprehensive approach established an efficient and versatile end-to-end framework for ECG classification. The results of our study highlight the potential of leveraging artificial intelligence in the screening of ECG exams, offering a promising solution for the rapid assessment and prioritization of patients in the ER.
  • conferenceObject
    2D Image-Based Atrial Fibrillation Classification
    (2021) DIAS, Felipe M.; SAMESIMA, Nelson; RIBEIRO, Adele; MORENO, Ramon A.; PASTORE, Carlos A.; KRIEGER, Jose E.; GUTIERREZ, Marco A.
    Atrial fibrillation (AF) is a common arrhythmia (0.5% worldwide prevalence) associated with an increased risk of various cardiovascular disorders, including stroke. Automated routine AF detection by Electrocardiogram (ECG) is based on the analysis of one-dimensional ECG signals and requires dedicated software for each type of device, limiting its wide use, especially with the rapid incorporation of telemedicine into the healthcare system. Here, we implement a machine learning method for AF classification using the region of interest (ROI) corresponding to the long DII lead automatically extracted from DICOM 12-lead ECG images. We observed 94.3%, 98.9%, 99.1%, and 92.2% for sensitivity, specificity, AUC, and F1 score, respectively. These results indicate that the proposed methodology performs similar to one-dimensional ECG signals as input, but does not require a dedicated software facilitating the integration into clinical practice, as ECGs are typically stored in PACS as 2D images.
  • article 0 Citação(ões) na Scopus
    Blood Pressure Estimation From Photoplethysmography by Considering Intra- and Inter-Subject Variabilities: Guidelines for a Fair Assessment
    (2023) COSTA, Thiago Bulhoes Da Silva; DIAS, Felipe Meneguitti; CARDENAS, Diego Armando Cardona; TOLEDO, Marcelo Arruda Fiuza De; LIMA, Daniel Mario De; KRIEGER, Jose Eduardo; GUTIERREZ, Marco Antonio
    Cardiovascular diseases are the leading causes of death, and blood pressure (BP) monitoring is essential for prevention, diagnosis, assessment, and treatment. Photoplethysmography (PPG) is a low-cost opto-electronic technique for BP measurement that allows the acquisition of a modulated light signal highly correlated with BP. There are several reports of methods to estimate BP from PPG with impressive results; in this study, we demonstrate that the previous results are excessively optimistic because of their train/test split configuration. To manage this limitation, we considered intra- and inter-subject data arrangements and demonstrated how they affect the results of feature-based BP estimation algorithms (i.e., XGBoost, LightGBM, and CatBoost) and signal-based algorithms (i.e., Residual U-Net, ResNet-18, and ResNet-LSTM). Inter-subject configuration performance is inferior to intra-subject configuration performance, regardless of the model. We also showed that, using only demographic attributes (i.e., age, sex, weight, and subject index number), a regression model achieved results comparable to those obtained in an intra-subject scenario.Although limited to a public clinical database, our findings suggest that algorithms that use an intra-subject setting without a calibration strategy may be learning to identify patients and not predict BP.