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Free Content Computer-aided detection of pulmonary tuberculosis on digital chest radiographs: a systematic review

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OBJECTIVE: To systematically review the diagnostic accuracy of computer-aided detection (CAD) of pulmonary tuberculosis (PTB) on digital chest radiographs (CXR).

DESIGN: We searched four databases for articles published between January 2010 and December 2015 comparing CAD of PTB on CXR to a microbiologic reference standard (smear, culture or polymerase chain reaction). We collected and summarised data on study design, CAD software and diagnostic accuracy (sensitivity, specificity, area under the curve [AUC]).

RESULTS: We included 5 of 455 articles identified by searching databases. PTB prevalence ranged from 18% to 60%, and human immunodeficiency virus (HIV) prevalence from 33% to 68%. All articles evaluated CAD4TB, the only commercially available software. AUC ranged from 0.71 to 0.84. Software settings that increased sensitivity resulted in important reductions in specificity, and vice versa. Risk of bias was low in prospective studies (n = 2), and high in retrospective studies (n = 3).

CONCLUSION: Evidence assessing CAD's diagnostic accuracy is limited by the small number of studies, most of which have important methodological limitations, the availability and evaluation of only one software programme, and limited generalisability to settings where PTB and HIV are less prevalent. Additional research is required.
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Keywords: TB diagnostics; chest X-ray; computer-aided detection; diagnostic technology; digital X-rays

Document Type: Research Article

Affiliations: 1: McGill International TB Center, Montreal, Canada 2: McGill International TB Center, Montreal, Respiratory Epidemiology and Clinical Research Unit, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada

Publication date: September 1, 2016

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on lung health world-wide.

    To share scientific research of immediate concern as rapidly as possible, The Union is fast-tracking the publication of certain articles from the IJTLD and publishing them on The Union website, prior to their publication in the Journal. Read fast-track articles.

    Certain IJTLD articles are also selected for translation into French, Spanish, Chinese or Russian. These are available on the Union website.

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