Artificial Intelligence Attack! The Rising Importance of Chagas Disease

Chagas disease (Chd) is a chronic condition with primarily cardiac sequelae that can persist and worsen many years after the initial infection, with a serious impact on healthcare systems. The PAHO estimated that 90% of new infections go undiagnosed, and about 70% of those infected are unaware of their condition. Additionally, less than 1% of the estimated population at risk has been tested. As a result, this leads to a delay in diagnosis, which increases morbidity and mortality from its complications, highlighting a clear need to expand access to diagnosis from a public health perspective. To mitigate this impact, Chd was included in the Millennium Development Goals and the Sustainable Development Goals of the 2030 Agenda for Sustainable Development (UN, 2018).

The gold standard for diagnosing Chd is serological testing for T. cruzi antibodies. The biggest challenge in Chd remains predicting which patients will develop the cardiac form, a leading cause of heart failure, especially in rural areas of Brazil. Notably, electrocardiography is an accessible and low-cost tool that can detect early signs of cardiac involvement in Chd. In recent years, AI-ECG (Electrocardiogram with artificial intelligence) models have been shown to diagnose cardiac conditions accurately; many have been trained and tested primarily on data from high-income countries. Furthermore, these models have been evaluated retrospectively on large historical datasets, with relatively few prospective external validation studies. These gaps in AI-ECG research need to be addressed.

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