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Comparing different versions of computer-aided detection products when reading chest X-rays for tuberculosis
Zhi Zhen Qin1, Rachael Barrett1, Shahriar Ahmed2
1Stop TB Partnership, Le Grand-Saconnex, Geneva, Switzerland.
PLOS Digital Health
|February 22, 2023
Summary
Newer versions of computer-aided detection (CAD) software for tuberculosis screening significantly outperform older versions. Continuous evaluation of CAD systems using local data is crucial for effective implementation in public health programs.
Area of Science:
- Medical Imaging
- Artificial Intelligence in Healthcare
- Public Health Diagnostics
Background:
- The World Health Organization (WHO) recommends computer-aided detection (CAD) for tuberculosis (TB) screening.
- Software updates necessitate ongoing performance evaluations for CAD systems.
- Previous evaluations of CAD4TB and qXR have been superseded by newer software versions.
Purpose of the Study:
- To compare the performance of upgraded CAD4TB and qXR software versions against their predecessors.
- To assess the programmatic impact of adopting newer CAD versions for TB screening.
- To evaluate CAD performance against radiologist readings and WHO's Target Product Profile (TPP).
Main Methods:
- A case-control study using 12,890 chest X-rays.
- Comparison of area under the receiver operating characteristic curve (AUC) for different CAD versions.
- Stratified analysis by age, TB history, gender, and patient source.
Main Results:
- Newer CAD4TB (v7) and qXR (v3) versions showed significantly improved AUC compared to older versions (v6 and v2, respectively).
- Newer CAD versions met WHO TPP criteria, while older versions did not.
- Both newer CAD versions equaled or surpassed human radiologist performance, with enhanced triage capabilities.
Conclusions:
- Newer CAD software versions demonstrate superior performance for TB screening and triage.
- Local data evaluation is essential before implementing CAD due to potential variations in neural networks.
- An independent evaluation center is needed to provide timely performance data on new CAD products.
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