Five Multimodal AI Configurations Versus Anaesthesiologists for Pecto-Intercostal Block Classification in an Archived-Image Reader Study of a Prospective CABG Cohort

Background/Objectives: We compared five general-purpose multimodal AI configurations with anaesthesiologists classifying sonographic pecto-intercostal fascial plane block spread.

Methods

This archived-image reader study used a prospective cohort of 120 ASA III adults undergoing isolated coronary artery bypass grafting at one centre. In June 2026, five free AI configurations and three experts classified identical sets of 8–10 left-sided frames. Direct binary comparisons used each expert’s labels in 115 block recipients; five no-block controls were separate. The senior expert reviewed expert labels before setting the final reference, precluding independent expert–AI accuracy comparison. Reference-conditioned balanced accuracy was defined as mean sensitivity and specificity.