{ "id": "AIBD-0578", "title": "AI-ECG mortality alerts reduce 90-day deaths in a randomized trial in Taiwan", "summary": "A Taiwanese randomized trial involving 15,965 patients found 90-day mortality of 3.6% with AI-ECG alerts versus 4.3% with usual care.", "date_observed": "2024-04-29", "date_basis": "source publication", "date_precision": "day", "benefit_status": "reported", "source_collection": null, "source_entry": null, "account": "An academic medical center and a community hospital in Taiwan tested AI-ECG alerts with 39 physicians and 15,965 patients. Patients were randomly assigned to AI-assisted care or usual care. Ninety-day all-cause mortality, the primary endpoint, was 3.6% versus 4.3%, respectively: hazard ratio 0.83, with a 95% confidence interval of 0.70–0.99. The prespecified high-risk subgroup had a hazard ratio of 0.69 (0.53–0.90). The trial covered ECGs collected from December 15, 2021, through April 30, 2022. Longer-term survival and generalizability to other health systems remain uncertain.", "category": "general benefit", "unexpected": false, "purpose": "Identify patients at high risk of death and prompt timely clinical assessment.", "system": "AI-ECG mortality prediction and physician alert system", "model_version": null, "developer": "National Defense Medical Center and Tri-Service General Hospital research team", "deployer": "An academic medical center and a community hospital in Taiwan", "location": "Taiwan", "domain": "Healthcare - mortality prevention", "segment": "ECG-based clinical decision support", "benefit_type": "Improved Physical Health", "taxonomy_note": null, "registry_ids": { "clinicaltrials_gov": "NCT05118035" }, "ratings": [ { "group": "personal", "depth": 5, "reason": "The randomized trial measured lower all-cause mortality within 90 days." } ], "ai_role": { "status": "assessed", "statement": "A convolutional neural network assessed ECGs and sent high-risk alerts to physicians. Clinicians selected further assessment and treatment. The trial evaluated this combined care pathway. The precise mechanism of the survival improvement remains uncertain." }, "evidence": [ { "kind": "peer-reviewed study", "citation": "Lin CS, Liu WT, Tsai DJ, et al. (2024). Nature Medicine 30:1461–1470. doi:10.1038/s41591-024-02961-4. Randomized trial conducted by the system's research team. Figures 1–4; Methods; Supplementary Note 1 and Figure 1.", "title": "AI-enabled electrocardiography alert intervention and all-cause mortality: a pragmatic randomized clinical trial", "url": "https://www.nature.com/articles/s41591-024-02961-4", "date": "2024-04-29", "written_by": "makers", "quote": null }, { "kind": "peer-reviewed study", "citation": "Hsieh PH, Lin C, Lin CS, et al. (2025). npj Digital Medicine 8:348. doi:10.1038/s41746-025-01735-7. Analysis of the same trial. Methods, limitations, and supplementary Tables 1–3.", "title": "Economic analysis of an AI-enabled ECG alert system: impact on mortality outcomes from a pragmatic randomized trial", "url": "https://www.nature.com/articles/s41746-025-01735-7", "date": "2025-06-11", "written_by": "deployer", "quote": null }, { "kind": "other", "citation": "Chin Lin, ECGSurvNet, commit 68e3b7c58491a38d731d43626f98443e53d035a5, January 21, 2022.", "title": "ECGSurvNet training code and model architecture", "url": "https://github.com/Imshepherd/ECGSurvNet/tree/68e3b7c58491a38d731d43626f98443e53d035a5", "date": "2022-01-21", "written_by": "makers", "quote": null } ], "replication": { "produced_by": [ "Routine ECGs were analyzed automatically, with warnings sent to physicians and risk reports available in the electronic health record.", "Physicians assessed alerted patients and selected care using their clinical judgment." ], "must_hold": [ "Reliable ECG transfer and clinicians able to assess alerts are likely requirements. Effectiveness in other health systems requires evaluation." ], "echoes": [] }, "paired_incident": null, "headline": "Taiwan AI-ECG alerts reduce mortality in a randomized trial", "metric": "3.6% versus 4.3%", "comparator": { "against": "Patients randomly assigned to usual care without AI-ECG alerts", "before": "4.3% mortality within 90 days", "after": "3.6% mortality within 90 days", "basis": "measured", "quote": "3.6% patients in the intervention group died within 90 days, compared to 4.3% in the control group", "url": "https://www.nature.com/articles/s41591-024-02961-4" }, "later": null, "value": null, "developer_country": "Taiwan", "deployer_country": "Taiwan", "unrated_because": null, "brief_notes": null, "brief": null, "revisions": [ { "date": "2026-10-23", "change": "Added the case.", "source": "https://www.nature.com/articles/s41591-024-02961-4", "editor": "AIBD" }, { "date": "2026-10-24", "change": "Read the original AI-ECG trial, extended data, supplementary protocol and registration, and followed its model reference to the original development study. Retained the economic paper for its additional cost analysis, explicitly as a reanalysis of the same patients. Recorded licensing interests and the restrictions on model weights and patient-level data.", "source": "https://www.nature.com/articles/s41591-024-02961-4", "editor": "AIBD" }, { "date": "2026-10-25", "change": "Identified the AI model, software, configuration, and human controls from the original paper, supplement, or author documentation.", "source": "https://www.nature.com/articles/s41591-024-02961-4", "editor": "AIBD" }, { "date": "2026-10-25", "change": "Reviewed the original evidence and supporting material; updated system details, methods, outcomes, limitations, costs, and source lineage.", "source": "https://www.nature.com/articles/s41591-024-02961-4", "editor": "AIBD" } ], "confidence": "claimed", "shade": "low", "claim_status": "The deployer's account", "claim_basis": "Sources: the makers' peer-reviewed study, the makers' other and the deployer's peer-reviewed study. The cited evidence includes no independent source and no finding by a regulator or court.", "profile": { "case_id": "AIBD-0578", "catalog_version": "1.0.0", "source_fingerprint": "cc0075c37b4f14bbce431c1c378ca0cccbdd66f0e70c1a1b0a674532f06bc4de", "collection_refs": [ { "collection_id": "aibd", "version": "snapshot-8bf7cfec9cb185aa" }, { "collection_id": "aibd", "version": "2026-10-25" } ], "source_ids": [ "AIBD-0578-source-0001", "AIBD-0578-source-0002", "AIBD-0578-source-0003" ], "families": { "strategic assessments": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial", "record_ids": [] }, "evaluations": { "state": "value_present", "value": { "kind": "identifiers", "identifiers": [ "NCT05118035" ], "role": "evaluations" }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The evaluation described in the cited original sources." }, "record_ids": [ "NCT05118035" ] }, "monetary observations": { "state": "value_present", "value": { "kind": "identifiers", "identifiers": [ "10.1038/s41746-025-01735-7" ], "role": "monetary observations" }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0002" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "A 90-day economic analysis of the randomized trial." }, "record_ids": [ "10.1038/s41746-025-01735-7" ] }, "institutional decisions": { "state": "value_present", "value": { "kind": "identifiers", "identifiers": [ "NCT05118035" ], "role": "institutional decisions" }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The registered clinical trial." }, "record_ids": [ "NCT05118035" ] } }, "fields": { "actors[]": { "state": "value_present", "value": { "kind": "text", "text": "Researchers at the National Defense Medical Center and Tri-Service General Hospital developed the system. Physicians at an academic center and a community hospital provided care." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Researchers at the National Defense Medical Center and Tri-Service General Hospital developed the system. Physicians at an academic center and a community hospital provided care." } }, "actors[].ownership_control": { "state": "not_reported", "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "reason": "The reviewed clinical sources identify the organizations involved, but do not establish their complete ownership or control arrangements.", "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The reviewed clinical sources identify the organizations involved, but do not establish their complete ownership or control arrangements." } }, "ai_contribution": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "ai_role": { "status": "assessed", "statement": "A convolutional neural network assessed ECGs and sent high-risk alerts to physicians. Clinicians selected further assessment and treatment. The trial evaluated this combined care pathway. The precise mechanism of the survival improvement remains uncertain." } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "ai_role" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "ai_relationship": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "category": "general benefit", "ai_role": { "status": "assessed", "statement": "A convolutional neural network assessed ECGs and sent high-risk alerts to physicians. Clinicians selected further assessment and treatment. The trial evaluated this combined care pathway. 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The cost study reuses the same trial." } }, "claims[].missingness": { "state": "value_present", "value": { "kind": "text", "text": "The precise deployed weights, longer-term survival, and the clinical actions that caused the mortality difference remain unresolved." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The precise deployed weights, longer-term survival, and the clinical actions that caused the mortality difference remain unresolved." } }, "claims[].proposition": { "state": "value_present", "value": { "kind": "text", "text": "AI-ECG alerts reduced 90-day mortality in the randomized comparison." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "AI-ECG alerts reduced 90-day mortality in the randomized comparison." } }, "cross_border_flows[]": { "state": "value_present", "value": { "kind": "text", "text": "The trial took place in Taiwan. The paper describes a private cloud, without reporting an international transfer of patient data." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The trial took place in Taiwan. The paper describes a private cloud, without reporting an international transfer of patient data." } }, "decisions[].action_outcome": { "state": "value_present", "value": { "kind": "text", "text": "Hospitals provided alerts to the intervention group while continuing usual clinical care." }, "provenance": { "kind": "source_review", "basis": "Methods and Supplementary Note 1; NCT05118035.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Hospitals provided alerts to the intervention group while continuing usual clinical care." } }, "decisions[].grounds": { "state": "value_present", "value": { "kind": "text", "text": "The trial protocol specified random allocation and a 90-day mortality outcome." }, "provenance": { "kind": "source_review", "basis": "Methods and Supplementary Note 1; NCT05118035.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The trial protocol specified random allocation and a 90-day mortality outcome." } }, "decisions[].institution_task": { "state": "value_present", "value": { "kind": "text", "text": "Participating hospitals tested whether mortality alerts improved survival." }, "provenance": { "kind": "source_review", "basis": "Methods and Supplementary Note 1; NCT05118035.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Participating hospitals tested whether mortality alerts improved survival." } }, "decisions[].success_criterion": { "state": "value_present", "value": { "kind": "text", "text": "The prespecified primary outcome was all-cause mortality within 90 days." }, "provenance": { "kind": "source_review", "basis": "Methods and Supplementary Note 1; NCT05118035.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The prespecified primary outcome was all-cause mortality within 90 days." } }, "deployment_stage": { "state": "value_present", "value": { "kind": "text", "text": "Clinical use within a trial at two hospitals in Taiwan." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Clinical use within a trial at two hospitals in Taiwan." } }, "economics[].amount": { "state": "value_present", "value": { "kind": "structured", "data": { "reported_currency": "USD", "original_cost_currency": "TWD", "mean_medical_cost_per_patient": { "AI": 6204, "usual_care": 5803 }, "incremental_medical_cost": 402, "incremental_medical_cost_95CI": [ 61, 735 ], "base_case_including_assumed_AI_price": { "incremental_cost": 409, "incremental_cost_95CI": [ 68, 743 ], "assumed_AI_service_price": 4, "ICER_per_death_averted": 59500, "ICER_95CI": [ -4657, 385950 ] }, "local_currency_reconstruction": "The exact conversion rate is not printed in the paper. No unverified TWD equivalent has been inserted." } }, "provenance": { "kind": "source_review", "basis": "Tables 1–2; the reported incremental medical cost is US$402 despite rounded group means differing by US$401.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0002" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Mean medical costs were US$6,204 with AI and US$5,803 with usual care. The base-case estimate was US$59,500 per death averted." } }, "economics[].costs[]": { "state": "value_present", "value": { "kind": "text", "text": "The analysis included hospital medical costs and assumed US$4 per AI-ECG service. It excluded development, staff training, maintenance, administration, and wider family or societal costs." }, "provenance": { "kind": "source_review", "basis": "Hsieh et al. 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(2025), Tables 1–2; Methods: Health resource utilization and cost; Statistical analysis; Discussion: limitations.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0002" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Patients randomly assigned to usual care supplied the comparison for costs and mortality." } }, "economics[].currency_price_basis": { "state": "value_present", "value": { "kind": "text", "text": "Hospital costs were recorded in New Taiwan dollars and reported in U.S. dollars using a Bank of Taiwan rate dated 18 November 2024. The paper does not state the numerical exchange rate." }, "provenance": { "kind": "source_review", "basis": "Hsieh et al. (2025), Tables 1–2; Methods: Health resource utilization and cost; Statistical analysis; Discussion: limitations.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0002" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Hospital costs were recorded in New Taiwan dollars and reported in U.S. dollars using a Bank of Taiwan rate dated 18 November 2024. The paper does not state the numerical exchange rate." } }, "economics[].gross_net": { "state": "value_present", "value": { "kind": "text", "text": "These figures describe additional expenditure for a survival benefit. They are not cash savings or net financial returns." }, "provenance": { "kind": "source_review", "basis": "Hsieh et al. (2025), Tables 1–2; Methods: Health resource utilization and cost; Statistical analysis; Discussion: limitations.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0002" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "These figures describe additional expenditure for a survival benefit. They are not cash savings or net financial returns." } }, "economics[].measure_type": { "state": "value_present", "value": { "kind": "text", "text": "Medical expenditure and additional cost per death averted." }, "provenance": { "kind": "source_review", "basis": "Hsieh et al. (2025), Tables 1–2; Methods: Health resource utilization and cost; Statistical analysis; Discussion: limitations.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0002" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Medical expenditure and additional cost per death averted." } }, "economics[].period_unit": { "state": "value_present", "value": { "kind": "text", "text": "Mean cost per patient over 90 days, and incremental cost per death averted." }, "provenance": { "kind": "source_review", "basis": "Hsieh et al. (2025), Tables 1–2; Methods: Health resource utilization and cost; Statistical analysis; Discussion: limitations.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0002" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Mean cost per patient over 90 days, and incremental cost per death averted." } }, "economics[].realization": { "state": "value_present", "value": { "kind": "text", "text": "Hospital expenditure was observed. The price of the AI service and the cost-effectiveness calculations were modeled." }, "provenance": { "kind": "source_review", "basis": "Hsieh et al. (2025), Tables 1–2; Methods: Health resource utilization and cost; Statistical analysis; Discussion: limitations.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0002" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Hospital expenditure was observed. The price of the AI service and the cost-effectiveness calculations were modeled." } }, "economics[].recipient_payer": { "state": "value_present", "value": { "kind": "text", "text": "Taiwan’s National Health Insurance was the stated perspective. Hospital records included insurance reimbursement and patients’ out-of-pocket spending." }, "provenance": { "kind": "source_review", "basis": "Hsieh et al. (2025), Tables 1–2; Methods: Health resource utilization and cost; Statistical analysis; Discussion: limitations.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0002" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Taiwan’s National Health Insurance was the stated perspective. Hospital records included insurance reimbursement and patients’ out-of-pocket spending." } }, "economics[].return_payback": { "state": "not_reported", "provenance": { "kind": "source_review", "basis": "Results and Discussion of the economic analysis.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0002" ], "reviewed_on": "2026-10-25" }, "reason": "The study did not estimate profit, a financial return, or a payback period.", "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The study did not estimate profit, a financial return, or a payback period." } }, "economics[].valuation_method": { "state": "value_present", "value": { "kind": "text", "text": "The authors divided additional costs by deaths averted and used 5,000 bootstrap samples to estimate uncertainty." }, "provenance": { "kind": "source_review", "basis": "Hsieh et al. (2025), Tables 1–2; Methods: Health resource utilization and cost; Statistical analysis; Discussion: limitations.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0002" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The authors divided additional costs by deaths averted and used 5,000 bootstrap samples to estimate uncertainty." } }, "evaluations[].ai_uplift": { "state": "value_present", "value": { "kind": "text", "text": "Randomization supports an effect of the alert-assisted care pathway. It does not identify which subsequent clinical actions produced the survival difference." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Randomization supports an effect of the alert-assisted care pathway. It does not identify which subsequent clinical actions produced the survival difference." } }, "evaluations[].comparator": { "state": "value_present", "value": { "kind": "text", "text": "Usual care without the AI-ECG report or high-risk alert during the 90-day follow-up." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Usual care without the AI-ECG report or high-risk alert during the 90-day follow-up." } }, "evaluations[].design": { "state": "value_present", "value": { "kind": "text", "text": "An unblinded, pragmatic randomized trial with patients assigned to alerts or usual care. Allocation used a random list of medical-record numbers prepared before enrollment." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "An unblinded, pragmatic randomized trial with patients assigned to alerts or usual care. Allocation used a random list of medical-record numbers prepared before enrollment." } }, "evaluations[].effect": { "state": "value_present", "value": { "kind": "structured", "data": { "mortality_percent": { "AI": 3.6, "usual_care": 4.3 }, "hazard_ratio": 0.83, "hazard_ratio_95CI": [ 0.7, 0.99 ], "high_risk_hazard_ratio": 0.69, "high_risk_95CI": [ 0.53, 0.9 ] } }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Mortality was 3.6% with alerts and 4.3% with usual care. The hazard ratio was 0.83 (95% CI, 0.70–0.99)." } }, "evaluations[].exposure": { "state": "value_present", "value": { "kind": "text", "text": "Patients entered from 15 December 2021 through 30 April 2022. A physician received an alert for the first high-risk ECG." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Patients entered from 15 December 2021 through 30 April 2022. A physician received an alert for the first high-risk ECG." } }, "evaluations[].id": { "state": "value_present", "value": { "kind": "text", "text": "NCT05118035" }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "NCT05118035" } }, "evaluations[].measurement_method": { "state": "value_present", "value": { "kind": "text", "text": "Researchers compared deaths recorded in hospital records within 90 days. Patients were censored at their last known follow-up." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Researchers compared deaths recorded in hospital records within 90 days. Patients were censored at their last known follow-up." } }, "evaluations[].metric": { "state": "value_present", "value": { "kind": "text", "text": "All-cause mortality within 90 days was the primary outcome." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "All-cause mortality within 90 days was the primary outcome." } }, "evaluations[].reproduction_materials": { "state": "value_present", "value": { "kind": "text", "text": "The article includes a protocol and randomization details. Training code is public. Patient data require ethics approval and secure access." }, "provenance": { "kind": "source_review", "basis": "Trial supplement; Code availability; economic paper, Data availability.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001", "AIBD-0578-source-0002", "AIBD-0578-source-0003" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The article includes a protocol and randomization details. Training code is public. Patient data require ethics approval and secure access." } }, "evaluations[].setting_sample": { "state": "value_present", "value": { "kind": "text", "text": "The analysis included 15,965 adults treated by 39 physicians at two hospitals in Taiwan." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The analysis included 15,965 adults treated by 39 physicians at two hospitals in Taiwan." } }, "evaluations[].uncertainty_limitations": { "state": "value_present", "value": { "kind": "text", "text": "The study was unblinded and concentrated in one health system. Deaths outside its records could be missed. Survival beyond 90 days was not established." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The study was unblinded and concentrated in one health system. Deaths outside its records could be missed. Survival beyond 90 days was not established." } }, "external_references[]": { "state": "value_present", "value": { "kind": "structured", "data": { "ClinicalTrials.gov": "NCT05118035" } }, "provenance": { "kind": "source_review", "basis": "Original study registration, inspected through the ClinicalTrials.gov API.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "NCT05118035" } }, "follow_up[]": { "state": "value_present", "value": { "kind": "text", "text": "The 2025 publication analyzes costs from the same trial. It does not extend clinical follow-up beyond 90 days." }, "provenance": { "kind": "source_review", "basis": "Hsieh et al. (2025), Methods and Discussion.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0002" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The 2025 publication analyzes costs from the same trial. It does not extend clinical follow-up beyond 90 days." } }, "human_oversight": { "state": "value_present", "value": { "kind": "text", "text": "Physicians reviewed the alerts and chose further tests and treatment. The system did not prescribe or administer care." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Physicians reviewed the alerts and chose further tests and treatment. The system did not prescribe or administer care." } }, "id": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "id": "AIBD-0578" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "id" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "infrastructure_dependencies[]": { "state": "value_present", "value": { "kind": "text", "text": "The trial used Philips 12-lead ECG machines, automatic uploads, a private cloud with an NVIDIA DGX-1, electronic records, and smartphone alerts." }, "provenance": { "kind": "source_review", "basis": "Methods: The AI-ECG system and intervention.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The trial used Philips 12-lead ECG machines, automatic uploads, a private cloud with an NVIDIA DGX-1, electronic records, and smartphone alerts." } }, "outcomes[].beneficiaries": { "state": "value_present", "value": { "kind": "text", "text": "Adult emergency and hospitalized patients whose physicians participated in the trial." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Adult emergency and hospitalized patients whose physicians participated in the trial." } }, "outcomes[].beneficiary_count": { "state": "value_present", "value": { "kind": "structured", "data": { "randomized_records": 16335, "excluded": 370, "analyzed": 15965, "AI": 8001, "usual_care": 7964, "physicians": 39, "high_risk": { "AI": 709, "usual_care": 688 } } }, "provenance": { "kind": "source_review", "basis": "Figure 1 and Methods: Participants; allocation and post-randomization exclusions.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The analysis included 8,001 patients assigned to AI alerts and 7,964 assigned to usual care. It does not identify individual lives saved." } }, "outcomes[].benefit_type": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "benefit_type": "Improved Physical Health" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "benefit_type" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "outcomes[].claim": { "state": "value_present", "value": { "kind": "text", "text": "Fewer patients died within 90 days when their physicians received AI-ECG alerts." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Fewer patients died within 90 days when their physicians received AI-ECG alerts." } }, "outcomes[].distribution": { "state": "value_present", "value": { "kind": "text", "text": "The trial included an academic center and a community hospital. Most patients came from the academic center, and the mortality difference was larger in the prespecified high-risk group." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The trial included an academic center and a community hospital. Most patients came from the academic center, and the mortality difference was larger in the prespecified high-risk group." } }, "outcomes[].duration": { "state": "value_present", "value": { "kind": "text", "text": "Mortality was measured for 90 days after enrollment." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Mortality was measured for 90 days after enrollment." } }, "outcomes[].id": { "state": "value_present", "value": { "kind": "text", "text": "AIBD-0578-outcome-01" }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "AIBD-0578-outcome-01" } }, "outcomes[].stakeholder_group": { "state": "value_present", "value": { "kind": "structured", "data": { "groups": [ "personal" ] } }, "provenance": { "kind": "curatorial", "basis": "The beneficiary groups correspond to the reviewed depth assessments.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "People." } }, "outcomes[].status": { "state": "value_present", "value": { "kind": "text", "text": "Observed in a randomized trial." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "Observed in a randomized trial." } }, "outcomes[].tradeoffs": { "state": "value_present", "value": { "kind": "text", "text": "The alert could lead to additional tests and treatment. The economic analysis found higher mean medical costs." }, "provenance": { "kind": "source_review", "basis": "Lin et al., Nature Medicine (2024), Results, Figures 1–4, Methods, and Supplementary Note 1.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The alert could lead to additional tests and treatment. 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Read the linked ECGSurvNet README and model architecture at the recorded commit.", "record_fields": [], "source_refs": [ "AIBD-0578-source-0001", "AIBD-0578-source-0003" ], "reviewed_on": "2026-10-25" }, "review_state": "reviewed", "coverage": "partial" }, "taxonomy_crosswalks[]": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "title": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "title": "AI-ECG mortality alerts reduce 90-day deaths in a randomized trial in Taiwan", "headline": "Taiwan AI-ECG alerts reduce mortality in a randomized trial" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "title", "headline" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "version": { "state": "value_present", "value": { "kind": "identifiers", "identifiers": [ "cc0075c37b4f14bbce431c1c378ca0cccbdd66f0e70c1a1b0a674532f06bc4de" ], "role": "SHA-256 of normalized original case data" }, "provenance": { "kind": "curatorial", "basis": "Content fingerprint refreshed after the October 25, 2026 source review.", "record_fields": [], "source_refs": [], "reviewed_on": "2026-10-25" }, "review_state": "record_mapped", "coverage": "complete" }, "workflow": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "account": "An academic medical center and a community hospital in Taiwan tested AI-ECG alerts with 39 physicians and 15,965 patients. Patients were randomly assigned to AI-assisted care or usual care. Ninety-day all-cause mortality, the primary endpoint, was 3.6% versus 4.3%, respectively: hazard ratio 0.83, with a 95% confidence interval of 0.70–0.99. The prespecified high-risk subgroup had a hazard ratio of 0.69 (0.53–0.90). The trial covered ECGs collected from December 15, 2021, through April 30, 2022. Longer-term survival and generalizability to other health systems remain uncertain.", "replication": { "produced_by": [ "Routine ECGs were analyzed automatically, with warnings sent to physicians and risk reports available in the electronic health record.", "Physicians assessed alerted patients and selected care using their clinical judgment." ], "must_hold": [ "Reliable ECG transfer and clinicians able to assess alerts are likely requirements. Effectiveness in other health systems requires evaluation." ], "echoes": [] } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "account", "replication" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" } }, "summary": { "total": 91, "addressed": 91, "known": 83, "reviewed": 76, "record_mapped": 11, "not_assessed": 4, "complete": false, "by_state": { "value_present": 83, "not_reported": 4, "unresolved": 0, "not_assessed": 4, "not_applicable": 0, "withheld": 0, "source_unavailable": 0 } } } }