AI test rules out a COVID-19 diagnosis within one hour in emergency departments

An artificial intelligence (AI) test has been shown to be able to rapidly screen patients arriving in emergency departments for COVID-19, using clinical information routinely available within the first hour of coming to hospital.

According to the CURIAL study, published yesterday in The Lancet Digital Health, the AI test correctly predicted the COVID-19 status of 92.3% of patients coming to emergency departments at the John Radcliffe Hospital in Oxford and the Horton General Hospital in Banbury during a two-week test period.

Compared against results of laboratory swab testing, the CURIAL AI test correctly ruled-out COVID 97.6% of the time.

The test was developed by infectious disease and clinical machine learning experts at the University of Oxford using routine healthcare data (blood tests and vital signs) extracted from electronic health records for 115,394 patients and 72,310 admissions. 

WHY IT MATTERS

Whereas swab testing typically takes 24 hours, the CURIAL screening test is optimised to quickly give negative results with high confidence excluding COVID-19 and maintaining flow through the hospital.

THE LARGER CONTEXT

The researchers at Oxford have received an award from the University Medical and Life Sciences Translational Fund, comprising devolved funding from the Medical Research Council and Wellcome Trust, and are working with Infectious Diseases and Emergency Department teams at the John Radcliffe Hospital to trial the CURIAL AI test in the clinical pathway.

A collaboration with University Hospitals Birmingham will allow the team to validate the AI test’s performance using data from a different NHS organisation. 

The team are also validating a rapid version of the CURIAL AI test that uses near-patient blood tests that can be performed in 10 minutes. A trial is expected to begin shortly at the John Radcliffe Hospital.

ON THE RECORD

Dr Andrew Soltan, NIHR academic clinical fellow (cardiology) at the John Radcliffe Hospital and a researcher at Oxford University’s Radcliffe department of medicine, said: “The CURIAL AI test offers clinical teams the potential to rapidly and confidently rule-out a diagnosis of COVID-19 for a large majority of the patients who do not have the infection, while identifying patients at higher risk of testing positive. The higher-risk patients can then be cared for in clinical areas with additional infection-control precautions while swab test results are awaited.”

Dr Ravi Pattanshetty, an A&E consultant at the John Radcliffe Hospital, said: “We are very excited at the prospect of being able to use a tool which, should it prove successful, will help hospitals make more informed and rapid decisions with regards to patient flow.”

David Clifton, professor of clinical machine learning at the department of engineering science, said: “With many of our clinical colleagues working on the front lines to fight COVID-19, data scientists in healthcare AI have a supporting role to play by constructing tools to help care for patients.”

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