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. 2020 Apr 14;10(1):6276.
doi: 10.1038/s41598-020-63084-7.

Evaluation of computer aided detection of tuberculosis on chest radiography among people with diabetes in Karachi Pakistan

Shifa Salman Habib  1 , Sana Rafiq  1 , Syed Mohammad Asad Zaidi  1 , Rashida Abbas Ferrand  2 , Jacob Creswell  3 , Bram Van Ginneken  4 , Wafa Zehra Jamal  5 , Kiran Sohail Azeemi  1 , Saira Khowaja  6 , Aamir Khan  6
Affiliations

Evaluation of computer aided detection of tuberculosis on chest radiography among people with diabetes in Karachi Pakistan

Shifa Salman Habib et al. Sci Rep. .

Abstract

Pakistan ranks fifth among high tuberculosis (TB) burden countries and also has seventh highest burden for diabetes mellitus (DM). DM increases the risk of developing TB and contributes to adverse TB treatment outcomes hence screening and integrated management for both diseases in high burden countries is suggested. Computer-Aided Detection for TB (CAD4TB) can potentially be used as triage tool in low resource settings to pre-screen individuals for Xpert MTB/RIF testing. The aim of this study was to evaluate the diagnostic accuracy and performance of CAD4TB software in people with diabetes (PWD) enrolled in a TB screening program in Karachi, Pakistan. A total of 694 individuals with a diagnosis of DM (of whom 31.1% were newly diagnosed) were screened with CAD4TB and simultaneously provided sputum for Xpert MTB/RIF testing. Of the 74 (10.7%) participants who had bacteriologically positive (MTB+) results on Xpert testing, 54 (73%) had a CAD4TB score >70; and 155 (25%) participants who tested MTB-negative had scores >70. The area under the receiver operator curve was 0.78 (95% CI: 0.77-0.80). Our study findings indicate that CAD4TB offers good diagnostic accuracy as a triage test for TB screening among PWD using Xpert MTB/RIF as the reference standard.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Area under the ROC curve using CAD4TB scores as predictor for MTB detection on Xpert MTB/RIF.
Figure 2
Figure 2
TB testing algorithm among DM diagnosed individuals visiting private TB diagnostic and treatment centers in Karachi, Pakistan (Q3 2016-Q2 2017).
Figure 3
Figure 3
: Comparison of performance of Xpert using a CAD4TB cut off 70 (a) and 50 (b) for a hypothetical population of 100,000 DM diagnosed individuals visiting private TB diagnostic and treatment centers in Karachi, Pakistan.
See this image and copyright information in PMC

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