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

[摘要] 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 18xe2x80x8a036 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; CARxc2xa0had a lower specificity (41%); saving fewer (36%) Xpert tests. The AUC for CAR was 0.74 (95% CI 0.73xe2x80x930.75). 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. More studies are needed to evaluate CAR using different screening approaches.

[学科分类] 呼吸医学