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计算机辅助检测在非洲肺结核病例发现期间的诊断准确性:系统性审查和元分析
Alex J Scott1,2, Tahlia Perumal1,2, Ameer Hohlfeld3
1Division of Pulmonology, Department of Medicine, Centre for Lung Infection and Immunity, University of Cape Town Lung Institute, Cape Town, South Africa.
Open forum infectious diseases
|February 8, 2024
概括
计算机辅助检测 (CAD) 在社区环境中对结核病 (TB) 查有希望,但在艾滋病毒流行地区的绩效数据有限. 需要进一步的研究来证实它的实用性,并解决方法方面的问题.
科学领域:
- 医疗成像医学成像
- 传染病诊断 传染病诊断 传染病诊断
- 公共卫生 公共卫生
背景情况:
- 计算机辅助检测 (CAD) 是一种潜在的结核病 (TB) 查工具.
- 关于CAD在社区环境中发现活跃病例 (ACF) 的实用性数据有限,特别是在艾滋病毒流行地区.
- 结核病查工具的性能可能会在艾滋病毒流行率高的人群中受到损害.
研究的目的:
- 系统地审查CAD的诊断准确性,以检测肺结核.
- 评估CAD作为一种选工具在社区基础上发现活跃病例中的实用性.
- 评估艾滋病毒流行环境对结核病查CAD性能的影响.
主要方法:
- 对2012年1月至2023年2月期间发表的文章进行系统审查.
- 包括使用CAD进行肺结核查的研究与微生物参考标准 (培养/NAAT) 相比.
- 使用PRISMA-DTA和QUADAS-2标准进行数据提取和质量评估.
主要成果:
- 五项研究符合资格标准;元分析显示聚合灵敏度为0.87和特异性为0.74.
- 性能指标低于世卫组织目标产品概况 (灵敏度≥0.90,特异性≥0.70).
- 在所有纳入的研究中注意到存在偏差和适用性问题的高风险;子组分析是不可能的.
结论:
- 在资源乏,艾滋病毒流行的非洲环境中,CAD可能是一个有用的,具有成本效益的结核病查工具.
- 方法上的局限性要求对发现的适用性和通用性保持谨慎.
- 需要进一步进行高质量的研究,以验证CAD在脆弱人群中的结核病查中的作用.
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