Inter-Observer Variability in the Detection and Interpretation of Chest X-Ray Anomalies in Adults in an Endemic Tuberculosis Area

Moifo, Boniface; Pefura-Yone, E.W.; Nguefack‐Tsague, Georges; Gharingam, Marie Laure; Tapouh, Jean Roger Moulion; Kengne, André Pascal; Amvene, Samuel Nko'o

doi:10.4236/ojmi.2015.53018

Cited by 11 publications

(6 citation statements)

References 13 publications

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“…Radiology images suffer from significant interreader variability, where 2 or more experts may disagree on the findings from a scan [ 7 , 8 , 40 - 43 ]. Sakurada et al [ 44 ], for instance, report low interreader κ values ranging from 0.24 to 0.63 for assessment of different pathologies from chest radiographs.…”

Section: Key Considerationsmentioning

confidence: 99%

“…Even if the image data are available, they may not be labeled. Radiology scans suffer from a high degree of interreader variability, where 2 or more radiologists label the data inconsistently [ 7 , 8 ]; this may lead to noise or uncertainty in the ground truth labels. The distribution of target classes may be heavily skewed, especially for rare pathologies.…”

Section: Introductionmentioning

confidence: 99%

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Key Technology Considerations in Developing and Deploying Machine Learning Models in Clinical Radiology Practice

Kulkarni¹,

Gawali²,

Kharat³

2021

JMIR Med Inform

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The use of machine learning to develop intelligent software tools for the interpretation of radiology images has gained widespread attention in recent years. The development, deployment, and eventual adoption of these models in clinical practice, however, remains fraught with challenges. In this paper, we propose a list of key considerations that machine learning researchers must recognize and address to make their models accurate, robust, and usable in practice. We discuss insufficient training data, decentralized data sets, high cost of annotations, ambiguous ground truth, imbalance in class representation, asymmetric misclassification costs, relevant performance metrics, generalization of models to unseen data sets, model decay, adversarial attacks, explainability, fairness and bias, and clinical validation. We describe each consideration and identify the techniques used to address it. Although these techniques have been discussed in prior research, by freshly examining them in the context of medical imaging and compiling them in the form of a laundry list, we hope to make them more accessible to researchers, software developers, radiologists, and other stakeholders.

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Section: Key Considerationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Key Technology Considerations in Developing and Deploying Machine Learning Models in Clinical Radiology Practice

Kulkarni¹,

Gawali²,

Kharat³

2021

JMIR Med Inform

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“…CT has advantages relative to CXR. Variable film and CXR reader quality can affect detection of CLs, and studies have shown poor interobserver agreement in detection of CLs on CXR [17, 18]. CT is more sensitive and specific for detection of CLs than CXR [4, 19, 20], has higher intra- and inter-reader agreement [20], and thus may better characterize the relationship between CLs and treatment response.…”

mentioning

confidence: 99%

Increasing Number and Volume of Cavitary Lesions on Chest Computed Tomography Are Associated With Prolonged Time to Culture Conversion in Pulmonary Tuberculosis

Hernández-Romieu

Little

Bernheim

et al. 2019

Open Forum Infectious Diseases

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Background Cavitary lesions (CLs) primarily identified by chest x-ray (CXR) have been associated with worse clinical outcomes among patients with pulmonary tuberculosis (PTB). Chest computed tomography (CT), which has better resolution and increased sensitivity to detect lung abnormalities, has been understudied in PTB patients. We compared detection of CLs by CT and CXR and assessed their association with time to sputum culture conversion (tSCC). Methods This was a retrospective cohort study of 141 PTB patients who underwent CT. We used multivariate Cox proportional hazards models to evaluate the association between CLs on CXR and the number and single largest volume of CLs on CT with tSCC. Results Thirty (21%) and 75 (53%) patients had CLs on CXR and CT, respectively. CT detected cavities in an additional 44 patients (31%) compared with CXR. After multivariable adjustment, we observed a negative association between CLs and tSCC, with an adjusted hazard ratio (aHR) of 0.56 (95% confidence interval [CI], 0.32 to 0.97) for single CLs and 0.31 (95% CI, 0.16 to 0.60) for multiple CLs present on CT. Patients with a CL volume ≥25 mL had a prolonged tSCC (aHR, 0.39; 95% CI, 0.21 to 0.72). CLs on CXR were not associated with increased tSCC after multivariable adjustment. Conclusions CT detected a larger number of cavities in patients with PTB relative to CXR. We observed an association between increasing number and volume of CLs on CT and delayed tSCC independent of sputum microscopy result. Our findings highlight a potential role for CT in the clinical and research setting as a tool to risk-stratify patients with PTB.

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“…Görüntüleme tekniğine ait kısıtlamalar ile birlikte hekimler arası uyuma ait bir çalışmada ise radyologlara göre klinisyenlerde yanlış pozitiflik oranı yüksek bildirilmiş ve PAG'ın en iyi şekilde yorumlanması için radyolog ile klinisyen arasında düzenli konsültasyon ihtiyacı vurgulanmıştır. 23,24 Acil servis hekimlerinin en sık yanlış yorumladığı tetkiklerden birisinin de PAG'ın olduğunu bildiren bir çalışmada, klinisyenlerin bilgi ve yorum becerilerinin geliştirmesine yönelik programlarla birlikte klinisyen ve radyolog arasında yeterli kooperasyon ve etkin bir geri bildirim sistemine sahip olunması gerektiği belirtilmiştir. 25 Çalışmamızda, aile hekimliği asistanlarının %79,60'ı (n=110) PAG eğitimini tıp fakültesinde mezuniyet öncesi aldığı, mezuniyet sonrası eğitimin yeterli düzeyde verilmediği, hem teorik hem de uygulamalı eğitim ihtiyacının hekimler tarafından gerekliliğinin belirtildiği gözlemlendi.…”

Section: Materyal Ve Metotunclassified

The Determination of Knowledge, Attitudes and Behaviors of Primary Health Care Assistants About The Evaluation of Chest X-ray: A Cross-Sectional Study

Cüce¹,

Sari²

2019

Ankara Medical Journal

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Posteroanterior akciğer grafisinin (PAG) etkin bir şekilde değerlendirilmesi, özellikle birinci basamak sağlık hizmetinde sık karşılaşılan solunum sistemi hastalıkları tanısında önemlidir. Çalışmamızda birinci basamak sağlık hizmeti veren Aile Hekimliği asistanlarının PAG değerlendirme konusundaki bilgi, tutum ve davranışlarının belirlenmesini amaçladık. Materyal ve Metot: Aile hekimliği asistanlarının PAG değerlendirme konusunda bilgi, tutum ve davranışlarını belirlemeye yönelik hazırlanmış, asistanların tanımlayıcı özelliklerini (yaş, cinsiyet, hizmet yılı, asistanlıktaki yılı) içeren anket soruları sorulmuştur. Bulgular: PAG değerlendirme konusunda asistanların %92,00'ı (n=126) eğitim aldığını belirtmiştir. Bu konuda alınan eğitimin %79,60'ı (n=109) mezuniyet öncesi eğitimi kapsamaktadır. PAG konusunda verilecek pratik eğitimin katkı sağlayacağını düşünenlerin oranı %93,50 (n=128), teorik eğitimin katkı sağlayacağını belirtenlerin oranı ise %98,50 (n=135) bulundu. Sonuç: PAG değerlendirmesine yönelik aile hekimliği asistanlarının gerek teorik gerekse pratik eğitimlerle eksikliklerinin giderilmesi ve/veya tecrübelerinin geliştirilmesi, klinik uygulamalarına katkı sağlayacaktır.

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Inter-Observer Variability in the Detection and Interpretation of Chest X-Ray Anomalies in Adults in an Endemic Tuberculosis Area

Cited by 11 publications

References 13 publications

Key Technology Considerations in Developing and Deploying Machine Learning Models in Clinical Radiology Practice

Key Technology Considerations in Developing and Deploying Machine Learning Models in Clinical Radiology Practice

Increasing Number and Volume of Cavitary Lesions on Chest Computed Tomography Are Associated With Prolonged Time to Culture Conversion in Pulmonary Tuberculosis

The Determination of Knowledge, Attitudes and Behaviors of Primary Health Care Assistants About The Evaluation of Chest X-ray: A Cross-Sectional Study

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