Evidence map›Paper›PMID 38949860›Full record

ArticleJMIR pediatrics and parenting2024

Chest X-Ray-Based Telemedicine Platform for Pediatric Tuberculosis Diagnosis in Low-Resource Settings: Development and Validation Study.

Juan J Gómez-Valverde, Ramón Sánchez-Jacob, José Luis Ribó, H Simon Schaaf, Lara García Delgado, Alicia Hernanz-Lobo, Daniel Capellán-Martín, Ángel Lancharro, Orvalho Augusto, Alberto L García-Basteiro and 3 more

Abstract read
In one paragraph

Article in JMIR pediatrics and parenting, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Juan J Gómez-ValverdeBiomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain.ORCID https://orcid.org/0000-0002-5073-5908
Ramón Sánchez-JacobDepartment of Radiology, Children's National Hospital & George Washington University School of Medicine, Washington, DC, United States.ORCID https://orcid.org/0000-0003-0100-3230
José Luis RibóHospital Universitari General de Catalunya, Barcelona, Spain.ORCID https://orcid.org/0009-0002-4045-9943
H Simon SchaafDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.ORCID https://orcid.org/0000-0001-5755-4133
Lara García DelgadoBiomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain.ORCID https://orcid.org/0000-0001-8325-7730
Alicia Hernanz-LoboPediatric Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain.ORCID https://orcid.org/0000-0002-9560-9104
Daniel Capellán-MartínBiomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain.ORCID https://orcid.org/0000-0002-9743-0845
Ángel LancharroRadiología Pediátrica Hospital Materno Infantil Gregorio Marañón, Madrid, Spain.ORCID https://orcid.org/0000-0001-9439-1951
Orvalho AugustoCentro de Investigacão em Saúde de Manhiça (CISM), Maputo, Mozambique.ORCID https://orcid.org/0000-0002-0005-3968
Alberto L García-BasteiroCentro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.ORCID https://orcid.org/0000-0002-2038-5505
Begoña Santiago-GarcíaPediatric Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain.ORCID https://orcid.org/0000-0002-4125-0423
Elisa López-VarelaCentro de Investigacão em Saúde de Manhiça (CISM), Maputo, Mozambique.ORCID https://orcid.org/0000-0002-6725-5687
María J Ledesma-CarbayoBiomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain.ORCID https://orcid.org/0000-0001-6846-3923

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTuberculosis (TB) remains a major cause of morbidity and death worldwide, with a significant impact on children, especially those under the age of 5 years. The complex diagnosis of pediatric TB, compounded by limited access to more accurate diagnostic tests, underscores the need for improved tools to enhance diagnosis and care in resource-limited settings.

objectiveThis study aims to present a telemedicine web platform, BITScreen PTB (Biomedical Image Technologies Screen for Pediatric Tuberculosis), aimed at improving the evaluation of pulmonary TB in children based on digital chest x-ray (CXR) imaging and clinical information in resource-limited settings.

methodsThe platform was evaluated by 3 independent expert readers through a retrospective assessment of a data set with 218 imaging examinations of children under 3 years of age, selected from a previous study performed in Mozambique. The key aspects assessed were the usability through a standardized questionnaire, the time needed to complete the assessment through the platform, the performance of the readers to identify TB cases based on the CXR, the association between the TB features identified in the CXRs and the initial diagnostic classification, and the interreader agreement of the global assessment and the radiological findings.

resultsThe platform's usability and user satisfaction were evaluated using a questionnaire, which received an average rating of 4.4 (SD 0.59) out of 5. The average examination completion time ranged from 35 to 110 seconds. In addition, the study on CXR showed low sensitivity (16.3%-28.2%) but high specificity (91.1%-98.2%) in the assessment of the consensus case definition of pediatric TB using the platform. The CXR finding having a stronger association with the initial diagnostic classification was air space opacification (χ21>20.38, P<.001). The study found varying levels of interreader agreement, with moderate/substantial agreement for air space opacification (κ=0.54-0.67) and pleural effusion (κ=0.43-0.72).

conclusionsOur findings support the promising role of telemedicine platforms such as BITScreen PTB in enhancing pediatric TB diagnosis access, particularly in resource-limited settings. Additionally, these platforms could facilitate the multireader and systematic assessment of CXR in pediatric TB clinical studies.

Indexed as

chest radiographlow-resource settingspediatric tuberculosisscreeningtelehealthtelemedicinetuberculosisusability

Identifiers

PMID38949860
PMCPMC11250038

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.