Automatic versus human reading of chest X-rays in the Zambia National Tuberculosis Prevalence Survey
OBJECTIVE: To compare the performance of automatic software (CAD4TB 5) in chest X-ray (CXR) reading with that of field (general practitioners) and central (radiologists) readers.
DESIGN: A retrospective study comparing the performance of human and automatic reading was conducted. Two scenarios for central reading were evaluated: abnormalities not consistent with TB were considered to be ‘normal' or ‘abnormal'. Sputum culture was defined as the reference standard. Measures derived from receiver operating characteristic analysis were used to assess readers' performances.
RESULTS: Of 46 099 participants, 23 838 cases included all survey information; of these, 106 cases were culture-confirmed TB-positive. The performance of CAD4TB 5 was similar to that of field and central readers. Although there were significant differences in specificity when compared with field readings (P = 0.002) and central readings considering the first scenario (P < 0.001), these differences were not substantial (93.2% vs. 92.6% and 98.4% vs. 99.6%, respectively).
CONCLUSIONp: The performance of automatic CXR readings is comparable with that of human experts in a TB prevalence survey setting using culture as reference.
Document Type: Research Article
Affiliations: 1: Diagnostic Image Analysis Group, Radboud University Medical Center, Nijmegen, Thirona, Nijmegen, The Netherlands 2: Ministry of Health Headquarters, Lusaka, Zambia; Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands 3: University Teaching Hospital, Lusaka, Zambia
Publication date: 01 August 2017
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