An evaluation of automated chest radiography reading software for tuberculosis screening among public- and private-sector patients

The European Respiratory Journal
Md Toufiq RahmanJacob Creswell

Abstract

Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert).Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored by CAR and graded by a radiologist. We compared CAR with the radiologist for sensitivity and specificity, area under the receiver operating characteristic curve (AUC), and calculated the potential Xpert tests saved.A total of 18 036 individuals were enrolled. TB prevalence by Xpert was 15%. The radiologist graded 49% of CXRs as abnormal, resulting in 91% sensitivity and 58% specificity. At a similar sensitivity, CAR had a lower specificity (41%), saving fewer (36%) Xpert tests. The AUC for CAR was 0.74 (95% CI 0.73-0.75). CAR performance declined with increasing age. The radiologist grading was superior across all sub-analyses.Using CAR can save Xpert tests, but the radiologist's specificity was superior. Differentiated CAR thresholds may be required for different populations. Access to, and costs of, human readers must be considered when deciding to use CAR software...Continue Reading

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Citations

May 23, 2017·The European Respiratory Journal·Cecily MillerGiovanni Battista Migliori
Mar 23, 2019·JAMA Network Open·Eui Jin HwangUNKNOWN DLAD Development and Evaluation Group
Nov 13, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Eui Jin HwangUNKNOWN Deep Learning-Based Automatic Detection Algorithm Development and Evaluation Group
Nov 25, 2019·Academic Radiology·Sagar Kulkarni, Saurabh Jha
Oct 30, 2020·Tropical Medicine and Infectious Disease·Jacob CreswellLucie Blok
Jul 22, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Gamuchirai TavazivaFaiz Ahmad Khan

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Methods Mentioned

BETA
X-ray

Software Mentioned

CAR
CAD4TB detection of TB
R
CAD4TB
pROC
GeneXpert
Xpert
OpenMRS

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