Computer-assisted chest radiography reading for tuberculosis screening in people living with diabetes mellitus.

Autor:	Koesoemadinata RC; Infectious Disease Research Centre, Department of Biomedical Sciences, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia., Kranzer K; London School of Hygiene & Tropical Medicine, London, UK, National and Supranational Reference Laboratory, Research Centre Borstel, Germany., Livia R; Infectious Disease Research Centre., Susilawati N; Infectious Disease Research Centre., Annisa J; Infectious Disease Research Centre., Soetedjo NNM; Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia., Ruslami R; Infectious Disease Research Centre, Department of Biomedical Sciences, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia., Philipsen R; Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands., van Ginneken B; Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands., Soetikno RD; Department of Radiology, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia., van Crevel R; Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands., Alisjahbana B; Infectious Disease Research Centre, Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia., Hill PC; Centre for International Health, University of Otago, Dunedin, New Zealand.
Jazyk:	angličtina
Zdroj:	The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease [Int J Tuberc Lung Dis] 2018 Sep 01; Vol. 22 (9), pp. 1088-1094.
DOI:	10.5588/ijtld.17.0827
Abstrakt:	Background: Diabetes mellitus is a significant risk factor for tuberculosis (TB). We evaluated the performance of computer-aided detection for tuberculosis (CAD4TB) in people living with diabetes mellitus (PLWD) in Indonesia. Methods: PLWD underwent symptom screening and chest X-ray (CXR); sputum was examined in those with positive symptoms and/or CXR. Digital CXRs were scored using CAD4TB and analysed retrospectively using clinical and microbiological diagnosis as a reference. The area under the receiver operator curve (AUC) of CAD4TB scores was determined, and an optimal threshold score established. Agreement between CAD4TB and the radiologist's reading was determined. Results: Among 346 included PLWD, seven (2.0%) had microbiologically confirmed and two (0.6%) had clinically diagnosed TB. The highest agreement of CAD4TB with radiologist reading was achieved using a threshold score of 70 (κ = 0.41, P < 0.001). The AUC for CAD4TB was 0.89 (95%CI 0.73-1.00). A threshold score of 65 for CAD4TB resulted in a sensitivity, specificity, positive predictive value and negative predictive value of respectively 88.9% (95%CI 51.8-99.7), 88.5% (95%CI 84.6-91.7), 17.0% (95%CI 7.6-30.8) and 99.6% (95%CI 98.2-100). With this threshold, 48 (13.9%) individuals needed microbiological examination and no microbiologically confirmed cases were missed. Conclusions: CAD4TB has potential as a triage tool for TB screening in PLWD, thereby significantly reducing the need for microbiological examination.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu