{"version":"6.9","hitCount":1,"request":{"queryString":"ext_id:40611485 AND src:med","internalQuery":"ext_id:40611485 AND src:med","resultType":"CORE","cursorMark":"*","pageSize":25,"sort":"","synonym":false},"resultList":{"result":[{"id":"40611485","source":"MED","pmid":"40611485","pmcid":"PMC12533671","fullTextIdList":{"fullTextId":["PMC12533671"]},"doi":"10.1161/jaha.125.042106","title":"Artificial Intelligence-Enabled ECGs for Atrial Fibrillation Identification and Enhanced Oral Anticoagulant Adoption: A Pragmatic Randomized Clinical Trial.","authorString":"Liu WT, Lin C, Lee CC, Chang CH, Fang WH, Tsai DJ, Lin WY, Hung Y, Chen KC, Lee CH, Tsai TN, Lin WS, Hung YJ, Lin SH, Tsai CS, Lin CS.","authorList":{"author":[{"fullName":"Liu WT","lastName":"Liu","firstName":"Wei-Ting","initials":"WT","authorId":{"type":"ORCID","value":"0000-0002-3817-4079"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Division of Cardiology, Department of Internal Medicine Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Lin C","lastName":"Lin","firstName":"Chin","initials":"C","authorId":{"type":"ORCID","value":"0000-0003-2337-2096"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Medical Technology Education Center, School of Medicine National Defense Medical Center Taipei Taiwan, R.O.C."},{"affiliation":"Department of Artificial Intelligence of Things Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."},{"affiliation":"School of Public Health National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Lee CC","lastName":"Lee","firstName":"Chiao-Chin","initials":"CC","authorId":{"type":"ORCID","value":"0000-0002-5220-7551"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Division of Cardiology, Department of Internal Medicine Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Chang CH","lastName":"Chang","firstName":"Chiao-Hsiang","initials":"CH","authorId":{"type":"ORCID","value":"0000-0003-1607-6512"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Division of Cardiology, Department of Internal Medicine Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Fang WH","lastName":"Fang","firstName":"Wen-Hui","initials":"WH","authorId":{"type":"ORCID","value":"0000-0002-0574-5736"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Medical Technology Education Center, School of Medicine National Defense Medical Center Taipei Taiwan, R.O.C."},{"affiliation":"Department of Family and Community Medicine, Department of Internal Medicine Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Tsai DJ","lastName":"Tsai","firstName":"Dung-Jang","initials":"DJ","authorId":{"type":"ORCID","value":"0000-0002-5531-0810"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Medical Technology Education Center, School of Medicine National Defense Medical Center Taipei Taiwan, R.O.C."},{"affiliation":"Department of Artificial Intelligence of Things Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Lin WY","lastName":"Lin","firstName":"Wen-Yu","initials":"WY","authorId":{"type":"ORCID","value":"0000-0002-4979-2921"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Division of Cardiology, Department of Internal Medicine Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Hung Y","lastName":"Hung","firstName":"Yuan","initials":"Y","authorId":{"type":"ORCID","value":"0000-0002-2199-8338"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Division of Cardiology, Department of Internal Medicine Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Chen KC","lastName":"Chen","firstName":"Kai-Chieh","initials":"KC","authorId":{"type":"ORCID","value":"0009-0000-9369-3851"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Graduate Institute of Life Sciences, National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Lee CH","lastName":"Lee","firstName":"Chun-Ho","initials":"CH","authorId":{"type":"ORCID","value":"0000-0001-9646-5715"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"School of Public Health National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Tsai TN","lastName":"Tsai","firstName":"Tsung-Neng","initials":"TN","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Division of Cardiology, Department of Internal Medicine Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Lin WS","lastName":"Lin","firstName":"Wei-Shiang","initials":"WS","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Division of Cardiology, Department of Internal Medicine Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Hung YJ","lastName":"Hung","firstName":"Yi-Jen","initials":"YJ","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Division of Endocrinology and Metabolism, Department of Internal Medicine Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Lin SH","lastName":"Lin","firstName":"Shih-Hua","initials":"SH","authorId":{"type":"ORCID","value":"0000-0001-6152-4885"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Division of Nephrology, Department of Internal Medicine Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Tsai CS","lastName":"Tsai","firstName":"Chien-Sung","initials":"CS","authorId":{"type":"ORCID","value":"0000-0002-1682-3269"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Division of Cardiovascular Surgery, Department of Surgery Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."}]}},{"fullName":"Lin CS","lastName":"Lin","firstName":"Chin-Sheng","initials":"CS","authorId":{"type":"ORCID","value":"0000-0002-5167-8327"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Division of Cardiology, Department of Internal Medicine Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C."},{"affiliation":"Medical Technology Education Center, School of Medicine National Defense Medical Center Taipei Taiwan, R.O.C."}]}}]},"authorIdList":{"authorId":[{"type":"ORCID","value":"0000-0001-6152-4885"},{"type":"ORCID","value":"0000-0001-9646-5715"},{"type":"ORCID","value":"0000-0002-0574-5736"},{"type":"ORCID","value":"0000-0002-1682-3269"},{"type":"ORCID","value":"0000-0002-2199-8338"},{"type":"ORCID","value":"0000-0002-3817-4079"},{"type":"ORCID","value":"0000-0002-4979-2921"},{"type":"ORCID","value":"0000-0002-5167-8327"},{"type":"ORCID","value":"0000-0002-5220-7551"},{"type":"ORCID","value":"0000-0002-5531-0810"},{"type":"ORCID","value":"0000-0003-1607-6512"},{"type":"ORCID","value":"0000-0003-2337-2096"},{"type":"ORCID","value":"0009-0000-9369-3851"}]},"dataLinksTagsList":{"dataLinkstag":["altmetrics","supporting_data"]},"journalInfo":{"issue":"14","volume":"14","journalIssueId":3978412,"dateOfPublication":"2025 Jul","monthOfPublication":7,"yearOfPublication":2025,"journal":{"medlineAbbreviation":"J Am Heart Assoc","title":"Journal of the American Heart Association","essn":"2047-9980","issn":"2047-9980","isoabbreviation":"J Am Heart Assoc","nlmid":"101580524"},"printPublicationDate":"2025-07-01"},"pubYear":"2025","pageInfo":"e042106","abstractText":"<h4>Background</h4>Atrial fibrillation (AF) is often underdiagnosed and undertreated by noncardiologists. This study evaluated whether artificial intelligence-enabled ECG (AI-ECG) alerts could improve AF diagnosis and non-vitamin K antagonist oral anticoagulant prescriptions by noncardiologists.<h4>Methods</h4>In this open-label, cluster randomized controlled trial (NCT05127460) at 2 hospitals in Taiwan, noncardiologists were randomized to an intervention group (AI-ECG alerts) or control group (usual care). Alerts were sent to physicians when AI-ECG identified AF in emergency or hospitalized patients at risk of stroke (CHA₂DS₂-VASc ≥1 for men, ≥2 for women), excluding those with prior AF or oral anticoagulant use. Primary end points included a non-vitamin K antagonist oral anticoagulant prescription within 90 days after discharge, new AF diagnosis, echocardiogram arrangements, and cardiologist visits. Secondary end points were ischemic stroke, cardiovascular death, and all-cause death.<h4>Results</h4>A total of 8857 and 8960 patients were treated by 120 and 113 noncardiologists in the intervention and control groups, respectively; 275 and 245 patients had AI-detected AF. The non-vitamin K antagonist oral anticoagulant prescription rate was significantly higher in the intervention group (23.3% versus 12.0%; hazard ratio [HR], 1.85 [95% CI, 1.11-3.07]). The intervention group also had a higher rate of AF diagnosis (HR, 1.40 [95% CI, 1.03-1.90]). No significant differences were observed in echocardiogram arrangements, cardiologist visits, or the rates of ischemic stroke, cardiovascular death, and all-cause death.<h4>Conclusions</h4>An AI-ECG alert for AF identification promoted non-vitamin K antagonist oral anticoagulant prescriptions among noncardiologists, thus reducing the disparity in AF care quality between cardiologists and noncardiologists.<h4>Registration</h4>URL: https://clinicaltrials.gov/; Unique identifier: NCT05127460.","affiliation":"Division of Cardiology, Department of Internal Medicine Tri-Service General Hospital, National Defense Medical Center Taipei Taiwan, R.O.C.","publicationStatus":"ppublish","language":"eng","pubModel":"Print-Electronic","pubTypeList":{"pubType":["Research Support, Non-U.S. Gov't","research-article","Multicenter Study","Randomized Controlled Trial","Pragmatic Clinical Trial","Journal Article"]},"meshHeadingList":{"meshHeading":[{"majorTopic_YN":"N","descriptorName":"Humans"},{"majorTopic_YN":"Y","descriptorName":"Atrial Fibrillation","meshQualifierList":{"meshQualifier":[{"majorTopic_YN":"N","abbreviation":"CO","qualifierName":"complications"},{"majorTopic_YN":"N","abbreviation":"DI","qualifierName":"diagnosis"},{"majorTopic_YN":"N","abbreviation":"DT","qualifierName":"drug therapy"},{"majorTopic_YN":"N","abbreviation":"MO","qualifierName":"mortality"},{"majorTopic_YN":"N","abbreviation":"PP","qualifierName":"physiopathology"}]}},{"majorTopic_YN":"Y","descriptorName":"Anticoagulants","meshQualifierList":{"meshQualifier":[{"majorTopic_YN":"N","abbreviation":"AD","qualifierName":"administration & dosage"}]}},{"majorTopic_YN":"Y","descriptorName":"Electrocardiography","meshQualifierList":{"meshQualifier":[{"majorTopic_YN":"N","abbreviation":"MT","qualifierName":"methods"}]}},{"majorTopic_YN":"N","descriptorName":"Administration, Oral"},{"majorTopic_YN":"Y","descriptorName":"Artificial Intelligence"},{"majorTopic_YN":"N","descriptorName":"Aged"},{"majorTopic_YN":"N","descriptorName":"Aged, 80 and over"},{"majorTopic_YN":"N","descriptorName":"Middle Aged"},{"majorTopic_YN":"N","descriptorName":"Taiwan","meshQualifierList":{"meshQualifier":[{"majorTopic_YN":"N","abbreviation":"EP","qualifierName":"epidemiology"}]}},{"majorTopic_YN":"N","descriptorName":"Female"},{"majorTopic_YN":"N","descriptorName":"Male"},{"majorTopic_YN":"Y","descriptorName":"Stroke","meshQualifierList":{"meshQualifier":[{"majorTopic_YN":"N","abbreviation":"ET","qualifierName":"etiology"},{"majorTopic_YN":"N","abbreviation":"PC","qualifierName":"prevention & control"}]}}]},"keywordList":{"keyword":["Artificial intelligence","Atrial fibrillation","Ischemic stroke","ECG","Randomized Clinical Trial","Deep Learning","Non–vitamin K Antagonist Oral Anticoagulants"]},"chemicalList":{"chemical":[{"name":"Anticoagulants","registryNumber":"0"}]},"subsetList":{"subset":[{"code":"IM","name":"Index Medicus"}]},"fullTextUrlList":{"fullTextUrl":[{"availability":"Subscription required","availabilityCode":"S","documentStyle":"doi","site":"DOI","url":"https://doi.org/10.1161/JAHA.125.042106"},{"availability":"Open access","availabilityCode":"OA","documentStyle":"html","site":"Europe_PMC","url":"https://europepmc.org/articles/PMC12533671"},{"availability":"Open access","availabilityCode":"OA","documentStyle":"pdf","site":"Europe_PMC","url":"https://europepmc.org/articles/PMC12533671?pdf=render"}]},"isOpenAccess":"Y","inEPMC":"Y","inPMC":"Y","citedByCount":8,"hasReferences":"Y","hasTextMinedTerms":"Y","hasDbCrossReferences":"N","hasPDF":"Y","hasBook":"N","hasSuppl":"Y","hasLabsLinks":"Y","hasData":"Y","license":"cc by-nc-nd","authMan":"N","epmcAuthMan":"N","nihAuthMan":"N","hasTMAccessionNumbers":"Y","tmAccessionTypeList":{"accessionType":["nct"]},"dateOfCompletion":"2025-07-16","dateOfCreation":"2025-07-04","dateOfRevision":"2026-08-29","electronicPublicationDate":"2025-07-03","firstPublicationDate":"2025-07-03","firstIndexDate":"2025-07-09","fullTextReceivedDate":"2025-12-04","hasEvaluations":"N"}]}}