ArticleScientific reports2015
Automated chest-radiography as a triage for Xpert testing in resource-constrained settings: a prospective study of diagnostic accuracy and costs.
Article in Scientific reports, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
47 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Machine and Deep Learning for Tuberculosis Detection on Chest X-Rays: Systematic Literature Review.Journal of medical Internet research · 2023Pooled it
- Chest X-ray Analysis With Deep Learning-Based Software as a Triage Test for Pulmonary Tuberculosis: An Individual Patient Data Meta-Analysis of Diagnostic Accuracy.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Pooled it
- Pooled it
- Enhanced Tuberculosis Diagnosis With Computer-aided Chest X-ray and Urine Lipoarabinomannan in Adults With HIV Admitted to Hospital (CASTLE Study): A Cluster Randomized Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Trial
- Utility of Xpert MTB/RIF Ultra and digital chest radiography for the diagnosis and treatment of TB in people living with HIV: a randomised controlled trial (XACT-TB).Transactions of the Royal Society of Tropical Medicine and Hygiene · 2023Trial
- Improving Tuberculosis Diagnosis Through Artificial Intelligence (CAD4TB) and Stool Xpert MTB/RIF Testing: A Prospective Study From Oromia, Ethiopia.Open forum infectious diseases · 2026Article
- Computer-aided detection to strengthen tuberculosis screening and diagnosis in Pakistan.Annals of medicine and surgery (2012) · 2025Article
- Utilization of Explainable Artificial Intelligence (XAI)-Powered Computer-Aided Detection (CAD) System on Chest X-Ray Abnormalities in Health Check-Ups.Yonago acta medica · 2025Article
- Implementation costs and cost-effectiveness of ultraportable chest X-ray with artificial intelligence in active case finding for tuberculosis in Nigeria.PLOS digital health · 2025Article
- Attitudes and perceptions of Thai medical students regarding artificial intelligence in radiology and medicine.BMC medical education · 2024Article
- Computer-aided detection of tuberculosis from chest radiographs in a tuberculosis prevalence survey in South Africa: external validation and modelled impacts of commercially available artificial intelligence software.The Lancet. Digital health · 2024Article
- Computer-aided detection thresholds for digital chest radiography interpretation in tuberculosis diagnostic algorithms.ERJ open research · 2024Article
- Comparing tuberculosis symptom screening to chest X-ray with artificial intelligence in an active case finding campaign in Northeast Nigeria.BMC global and public health · 2023Article
- Artificial Intelligence in Paediatric Tuberculosis.Pediatric radiology · 2023Review
- Chest Radiography of Tuberculosis: Determination of Activity Using Deep Learning Algorithm.Tuberculosis and respiratory diseases · 2023Article
- Artificial Intelligence-Based Software with CE Mark for Chest X-ray Interpretation: Opportunities and Challenges.Diagnostics (Basel, Switzerland) · 2023Review
- Computer-aided diagnostic accuracy of pulmonary tuberculosis on chest radiography among lower respiratory tract symptoms patients.Frontiers in public health · 2023Article
- How does artificial intelligence in radiology improve efficiency and health outcomes?Pediatric radiology · 2022Review
- Portable digital X-ray for TB pre-diagnosis screening in rural communities in Nigeria.Public health action · 2022Article
- Spatially targeted digital chest radiography to reduce tuberculosis in high-burden settings: A study of adaptive decision making.Epidemics · 2022Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Molecular tests hold great potential for tuberculosis (TB) diagnosis, but are costly, time consuming, and HIV-infected patients are often sputum scarce. Therefore, alternative approaches are needed. We evaluated automated digital chest radiography (ACR) as a rapid and cheap pre-screen test prior to Xpert MTB/RIF (Xpert). 388 suspected TB subjects underwent chest radiography, Xpert and sputum culture testing. Radiographs were analysed by computer software (CAD4TB) and specialist readers, and abnormality scores were allocated. A triage algorithm was simulated in which subjects with a score above a threshold underwent Xpert. We computed sensitivity, specificity, cost per screened subject (CSS), cost per notified TB case (CNTBC) and throughput for different diagnostic thresholds. 18.3% of subjects had culture positive TB. For Xpert alone, sensitivity was 78.9%, specificity 98.1%, CSS $13.09 and CNTBC $90.70. In a pre-screening setting where 40% of subjects would undergo Xpert, CSS decreased to $6.72 and CNTBC to $54.34, with eight TB cases missed and throughput increased from 45 to 113 patients/day. Specialists, on average, read 57% of radiographs as abnormal, reducing CSS ($8.95) and CNTBC ($64.84). ACR pre-screening could substantially reduce costs, and increase daily throughput with few TB cases missed. These data inform public health policy in resource-constrained settings.
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