Adaptive AI for Cardiovascular Event Adjudication: Cardiovascular Event Adjudication Across Different Definitions in the ODYSSEY OUTCOMES and EUCLID Trials

After brief adaptation, a single trial derived AI algorithm can adjudicate similar (MI and stroke) and new endpoints (CV death and bleeding) in a second trial and replicate the EUCLID primary outcome treatment effect. A hybrid approach with humans adjudicating those suspected events with the lowest 30% of ADAPT-CEC prediction certainty was superior to ADAPT-CEC alone or GPT 4.0 alone and replicated the EUCLID primary outcome treatment effect. Prospective studies of adaptive AI adjudication are needed to determine future trial implementation.