Artificial Intelligence Methods for Rapid Vascular Access Aneurysm Classification in Remote or In-Person Settings.

Background Innovations in artificial intelligence (AI) have proven to be effective contributors to high-quality health care. We examined the beneficial role AI can play in noninvasively grading vascular access aneurysms to reduce high-morbidity events, such as rupture, in ESRD patients on hemodialysis. Methods Our AI instrument noninvasively examines and grades aneurysms in both arteriovenous fistulas and arteriovenous grafts. Aneurysm stages were adjudicated by 3 vascular specialists, based on a grading system that focuses on actions that need to be taken. Our automatic classification of aneurysms builds on 2 components: (a) the use of smartphone technology to capture aneurysm appearance and (b) the analysis of these images using a cloud-based convolutional neural network (CNN). Results There was a high degree of correlation between our noninvasive AI instrument and the results of the adjudication by the vascular experts. Our results indicate that CNN can automatically classify aneurysms. We achieved a >90% classification accuracy in the validation images. Conclusion This is the first quality improvement project to show that an AI instrument can reliably grade vascular access aneurysms in a noninvasive way, allowing rapid assessments to be made on patients who would otherwise be at risk for highly morbid events. Moreover, these AI-assisted assessments can be made without having to schedule separate appointments and potentially even via telehealth.