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Inteligencia artificial y medicina: los beneficios y riesgos de la cardiología digital La cardiología digital tiene sus limitaciones. Pexels
La inteligencia artificial es una disciplina en constante evolución , que busca mejorar la capacidad de las máquinas para realizar tareas de manera autónoma, que ha demostrado ser una herramienta útil en diversas áreas de la medicina y la cardiología no es la excepción.
Actualmente los avances permiten la creación de algoritmos y modelos de aprendizaje automático que pueden analizar grandes cantidades de datos y ayudar a los médicos en el diagnóstico, tratamiento y pronóstico de enfermedades cardiovasculares.
Aunque su uso tiene muchos beneficios potenciales, también tiene limitaciones y algunos posibles peligros , según declaró un panel de expertos que participó en el Congreso de 2023 de la Sociedad Europea de Cardiología en Ámsterdam.
De sus beneficios... La salud digital y la inteligencia artificial contribuirían al autocuidado de los pacientes. Uno de ellos es la teleconsulta, ubicada entre los usos más habituales de la salud digital, que se caracteriza por permitir a los médicos llegar a lugares de difícil acceso , ya sea por razones de distancia, de seguridad para un diagnóstico inicial.
De manera similar, la tele-interconsulta hace posible la comunicación entre profesionales de la salud que se encuentran en ciudades o países distantes, lo cual puede ser muy útil y permite crear equipos de trabajo denominados 'teams' para resolución de casos complejos, como por ejemplo los Heart Teams (donde se discuten los implantes o recambios valvulares aórticos, entre otras cosas,) o los Neuro Vascular Teams (en pacientes con enfermedad carotídea o necesidad de una intervención denominada 'cierre de foramen oval permeable' en pacientes con stroke), son algunos de los ejemplos.
Otro instrumento de la salud digital son los dispositivos llamados en inglés wearables, que generan datos mientras la persona los lleva puestos , como el anillo conocido como Oura ring, que registra cuántas horas dormimos y la duración de cada una de las etapas del sueño para mejorar el descanso, o los relojes que detectan el ritmo de los latidos del corazón.
Pero cuando hablamos de los métodos por imágenes que usamos cotidianamente en cardiología, la penetración de la salud digital es aún mayor: en resonancia magnética , por ejemplo, existen herramientas que facilitan la adquisición de las imágenes con una reducción significativa del tiempo que el paciente tiene que estar dentro del resonador (muchos pacientes no soportan mucho tiempo dentro del mismo y esto limita el estudio).
En tomografía cardíaca la inteligencia artificial nos permite evaluar el flujo coronario de manera no invasiva , cosa que antes de la misma solo podía ser evaluada a través de un cateterismo.
No podemos dejar de mencionar las plataformas de telemonitoreo , que es el seguimiento remoto de pacientes con afecciones clínicas mediante un conjunto de sensores asociados a una plataforma digital que permiten capturar los datos necesarios sobre el estado de salud, procesarlos y enviarlos a una central de monitoreo donde un equipo de profesionales médicos con amplia experiencia y especialización en cada área de cobertura, realiza el seguimiento continuo del paciente; estas plataformas hoy en día se aplican a patologías como la insuficiencia cardíaca o la rehabilitación cardiovascular.
...a sus limitaciones Según Alan Fraser, del Hospital Universitario de Gales en Cardiff, el rendimiento y la precisión de estos dispositivos varía mucho entre ellos . Fraser compartió las historias de tres pacientes cuyos dispositivos no detectaron eventos cardiacos potencialmente mortales , incidiendo así en que todavía no tenemos evidencias de que los dispositivos portátiles tengan un impacto positivo en los pacientes.
Se ha demostrado que ChatGPT puede responder de forma precisa a preguntas simples sobre cardiología, sin embargo, no tiene la capacidad de responder a preguntas complejas e informes , casos en los que puede ser extremadamente poco fiable.
Existen, por tanto, grandes riesgos en el uso de la inteligencia artificial para gestionar datos cardiológicos complejos , ya que carece del entendimiento del contexto clínico necesario para interpretar los datos de forma correcta. Además, en la actualidad no tiene la capacidad de diferenciar entre la necesidad de tratamiento agudo frente a crónico y se le escapan conceptos clave, como las pruebas de laboratorio esenciales y las recomendaciones sobre fármacos contraindicados.
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