Artificial intelligence (AI) is revolutionizing big data analytics. In this issue of The American Journal of Gastroenterology, Ahn et al. introduce the AI-cirrhosis-electrocardiogram score that can grade the electrophysiologic cardiac changes present in patients with cirrhosis. Apart from showing excellent accuracy to identify cirrhosis, the AI-cirrhosis-electrocardiogram algorithm identified a biological gradient and signal reversibility after transplantation. Clinical applicability needs to be determined. Some concerns inherent to the use of AI are discussed, including the need to verify that the quality of data used for machine training is optimal. The black box nature of AI-identified associations is discussed, along with the lack of pathophysiologic coherence allowing intuitive medical reasoning.
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