Development and Validation of a Deep Learning Model for Automated View Classification of Pediatric Focused Assessment with Sonography for Trauma (FAST)

The pediatric Focused Assessment with Sonography for Trauma (FAST) is a sequence of ultrasound views rapidly performed by the clinician to diagnose hemorrhage. One limitation of FAST is inconsistent acquisition of required views. We sought to develop a deep learning model and classify FAST views using a heterogeneous dataset of pediatric FAST. This study of diagnostic test developed and tested a deep learning model for view classification of archived real-world pediatric FAST studies collected from two pediatric emergency departments. FAST frames were randomly distributed to training, validation, and test datasets in a 70:20:10 ratio; each patient was represented in only one dataset to maintain sample independence. The outcome was the prediction accuracy of the model in classifying FAST frames and video clips. FAST studies performed by 30 different clinicians from 699 injured children included 4,925 videos representing 1,062,612 frames from children who were a median of 9 years old. On test dataset, the overall view classification accuracy for the model was 93.4% (95% CI: 93.3-93.6) for frames and 97.8% (95% CI: 96.0-99.0) for video clips. Frames were correctly classified with an accuracy of 96.0% (95% CI: 95.9-96.1) for cardiac, 99.8% (95% CI: 99.8-99.8) for thoracic, 95.2% (95% CI: 95.0-95.3) for abdominal upper quadrants, and 95.9% (95% CI: 95.8-96.0) for suprapubic. A deep learning model can be developed to accurately classify pediatric FAST views. Accurate view classification is the important first step to support developing a consistent and accurate multi-stage deep learning model for pediatric FAST interpretation.