Artificial Intelligence in Predicting Clinical Outcome in COVID-19 Patients from Clinical, Biochemical and a Qualitative Chest X-Ray Scoring System

Abstract Background There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886–0.979, 100% sensitivity, 81% specificity). Conclusions Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units.

Download Full-text

Current limitations to identify COVID-19 using artificial intelligence with chest X-ray imaging

Health and Technology ◽

10.1007/s12553-021-00520-2 ◽

2021 ◽

Vol 11 (2) ◽

pp. 411-424 ◽

Cited By ~ 1

Author(s):

José Daniel López-Cabrera ◽

Rubén Orozco-Morales ◽

Jorge Armando Portal-Diaz ◽

Orlando Lovelle-Enríquez ◽

Marlén Pérez-Díaz

Keyword(s):

Artificial Intelligence ◽

X Ray ◽

X Ray Imaging ◽

Chest X Ray

Download Full-text

Artificial Intelligence Framework for Efficient Detection and Classification of Pneumonia Using Chest Radiography Images

10.21203/rs.3.rs-66836/v2 ◽

2021 ◽

Author(s):

Ali Mohammad Alqudah ◽

Shoroq Qazan ◽

Ihssan S. Masad

Keyword(s):

Artificial Intelligence ◽

Input Image ◽

Image Size ◽

X Ray ◽

Softmax Classifier ◽

Non Invasive ◽

Efficient Detection ◽

X Ray Imaging ◽

Chest X Ray

Abstract BackgroundChest diseases are serious health problems that threaten the lives of people. The early and accurate diagnosis of such diseases is very crucial in the success of their treatment and cure. Pneumonia is one of the most widely occurred chest diseases responsible for a high percentage of deaths especially among children. So, detection and classification of pneumonia using the non-invasive chest x-ray imaging would have a great advantage of reducing the mortality rates.ResultsThe results showed that the best input image size in this framework was 64 64 based on comparison between different sizes. Using CNN as a deep features extractor and utilizing the 10-fold methodology the propose artificial intelligence framework achieved an accuracy of 94% for SVM and 93.9% for KNN, a sensitivity of 93.33% for SVM and 93.19% for KNN and a specificity of 96.68% for SVM and 96.60% for KNN.ConclusionsIn this study, an artificial intelligence framework has been proposed for the detection and classification of pneumonia based on chest x-ray imaging with different sizes of input images. The proposed methodology used CNN for features extraction that were fed to two different types of classifiers, namely, SVM and KNN; in addition to the SoftMax classifier which is the default CNN classifier. The proposed CNN has been trained, validated, and tested using a large dataset of chest x-ray images contains in total 5852 images.

Download Full-text

Current limitations to identify covid-19 using artificial intelligence with chest x-ray imaging (part ii). The shortcut learning problem

Health and Technology ◽

10.1007/s12553-021-00609-8 ◽

2021 ◽

Author(s):

José Daniel López-Cabrera ◽

Rubén Orozco-Morales ◽

Jorge Armando Portal-Díaz ◽

Orlando Lovelle-Enríquez ◽

Marlén Pérez-Díaz

Keyword(s):

Artificial Intelligence ◽

Learning Problem ◽

X Ray ◽

X Ray Imaging ◽

Chest X Ray

Download Full-text

The Added Effect of Artificial Intelligence on Physicians’ Performance in Detecting Thoracic Pathologies on CT and Chest X-ray: A Systematic Review

Diagnostics ◽

10.3390/diagnostics11122206 ◽

2021 ◽

Vol 11 (12) ◽

pp. 2206

Author(s):

Dana Li ◽

Lea Marie Pehrson ◽

Carsten Ammitzbøl Lauridsen ◽

Lea Tøttrup ◽

Marco Fraccaro ◽

...

Keyword(s):

Artificial Intelligence ◽

Systematic Review ◽

Assessment Tool ◽

Cochrane Library ◽

Original Research ◽

Quality Assessment Tool ◽

Bias Assessment ◽

X Ray ◽

Chest X Ray ◽

Sensitivity Specificity

Our systematic review investigated the additional effect of artificial intelligence-based devices on human observers when diagnosing and/or detecting thoracic pathologies using different diagnostic imaging modalities, such as chest X-ray and CT. Peer-reviewed, original research articles from EMBASE, PubMed, Cochrane library, SCOPUS, and Web of Science were retrieved. Included articles were published within the last 20 years and used a device based on artificial intelligence (AI) technology to detect or diagnose pulmonary findings. The AI-based device had to be used in an observer test where the performance of human observers with and without addition of the device was measured as sensitivity, specificity, accuracy, AUC, or time spent on image reading. A total of 38 studies were included for final assessment. The quality assessment tool for diagnostic accuracy studies (QUADAS-2) was used for bias assessment. The average sensitivity increased from 67.8% to 74.6%; specificity from 82.2% to 85.4%; accuracy from 75.4% to 81.7%; and Area Under the ROC Curve (AUC) from 0.75 to 0.80. Generally, a faster reading time was reported when radiologists were aided by AI-based devices. Our systematic review showed that performance generally improved for the physicians when assisted by AI-based devices compared to unaided interpretation.

Download Full-text

Which role for chest x-ray score in predicting the outcome in COVID-19 pneumonia?

European Radiology ◽

10.1007/s00330-020-07504-2 ◽

2020 ◽

Author(s):

Roberto Maroldi ◽

Paolo Rondi ◽

Giorgio Maria Agazzi ◽

Marco Ravanelli ◽

Andrea Borghesi ◽

...

Keyword(s):

Patient Outcome ◽

Scoring System ◽

Clinical Decision Making ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Lung Involvement ◽

X Ray ◽

Entire Cohort ◽

Discharged Patients ◽

Chest X Ray

Abstract Objective We aim to demonstrate that a chest X-ray (CXR) scoring system for COVID-19 patients correlates with patient outcome and has a prognostic value. Methods This retrospective study included CXRs of COVID-19 patients that reported the Brixia score, a semi-quantitative scoring system rating lung involvement from 0 to 18. The highest (H) and lowest (L) values were registered along with scores on admission (A) and end of hospitalization (E). The Brixia score was correlated with the outcome (death or discharge). Results A total of 953 patients met inclusion criteria. In total, 677/953 were discharged and 276/953 died during hospitalization. A total of 524/953 had one CXR and 429/953 had more than one CXR. H-score was significantly higher in deceased (median, 12; IQR 9–14) compared to that in discharged patients (median, 8; IQR 5–11) (p < 0.0001). In 429/953 patients with multiple CXR, A-score, L-score, and E-score were higher in deceased than in discharged patients (A-score 9 vs 8; p = 0.039; L-score 7 vs 5; p < 0.0003; E-score 12 vs 7; p < 0.0001). In the entire cohort, logistic regression showed a significant predictive value for age (p < 0.0001, OR 1.13), H-score (p < 0.0001, OR 1.25), and gender (p = 0.01, male OR 1.67). AUC was 0.863. In patients with ≥ 2 CXR, A-, L-, and E-scores correlated significantly with the outcome. Cox proportional hazards regression indicated age (p < 0.0001, HR 4.17), H-score (< 9, HR 0.36, p = 0.0012), and worsening of H-score vs A score > 3 (HR 1.57, p = 0.0227) as associated with worse outcome. Conclusions The Brixia score correlates strongly with disease severity and outcome; it may support the clinical decision-making, particularly in patients with moderate-to-severe signs and symptoms. The Brixia score should be incorporated in a prognostic model, which would be desirable, particularly in resource-constraint scenarios. Key Points • To demonstrate the importance of the Brixia score in assessing and monitoring COVID-19 lung involvement. • The Brixia score strongly correlates with patient outcome and can be easily implemented in the routine reporting of CXR.

Download Full-text

Sensitivity and specificity of artificial intelligence with Microsoft Azure in detecting pneumothorax in emergency department: A pilot study

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907920948994 ◽

2020 ◽

pp. 102490792094899

Author(s):

Kwok Hung Alastair Lai ◽

Shu Kai Ma

Keyword(s):

Artificial Intelligence ◽

Emergency Department ◽

Sensitivity And Specificity ◽

National Institutes Of Health ◽

Dramatic Improvement ◽

X Ray ◽

Training Images ◽

Normal Chest ◽

Chest X Ray ◽

Microsoft Azure

Background: Artificial intelligence is becoming an increasingly important tool in different medical fields. This article aims to evaluate the sensitivity and specificity of artificial intelligence trained with Microsoft Azure in detecting pneumothorax. Methods: A supervised learning artificial intelligence is trained with a collection of X-ray images of pneumothorax from National Institutes of Health chest X-ray dataset online. A subset of the image dataset focused on pneumothorax is used in training. Two artificial intelligence programs are trained with different numbers of training images. After the training, a collection of pneumothorax X-ray images from patient attending emergency department is retrieved through the Clinical Data Analysis & Reporting System. In total, 115 pneumothorax patients and 60 normal inpatients are recruited. The pneumothorax chest X-ray and the resolution chest X-ray of the above patient group and a collection of normal chest X-ray from inpatients without pneumothorax will be retrieved, and these three sets of images will then undergo testing by artificial intelligence programs to give a probability of being a pneumothorax X-ray. Results: The sensitivity of artificial intelligence-one is 33.04%, and the specificity is at least 61.74%. The sensitivity of artificial intelligence-two is 46.09%, and the specificity is at least 71.30%. The dramatic improvement of 46.09% in sensitivity and improvement of 15.48% in specificity by addition of around 1000 X-ray images is encouraging. The mean improvement of AI-two over AI-one is 19.7% increase in probability difference. Conclusions: We should not rely on artificial intelligence in diagnosing pneumothorax X-ray solely by our models and more training should be expected to explore its full function.

Download Full-text

A chest x-ray scoring system for low birth weight babies

Clinical Radiology ◽

10.1016/s0009-9260(05)82240-8 ◽

1990 ◽

Vol 42 (5) ◽

pp. 378-379

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Scoring System ◽

X Ray ◽

Low Birth Weight Babies ◽

Chest X Ray

Download Full-text

Artificial Intelligence Framework for Efficient Detection and Classification of Pneumonia Using Chest Radiography Images

10.21203/rs.3.rs-66836/v1 ◽

2020 ◽

Author(s):

Ali Mohammad Alqudah ◽

Shoroq Qazan ◽

Ihssan S. Masad

Keyword(s):

Artificial Intelligence ◽

Input Image ◽

Image Size ◽

X Ray ◽

Softmax Classifier ◽

Non Invasive ◽

Efficient Detection ◽

X Ray Imaging ◽

Chest X Ray

Abstract BackgroundChest diseases are serious health problems that threaten the lives of people. The early and accurate diagnosis of such diseases is very crucial in the success of their treatment and cure. Pneumonia is one of the most widely occurred chest diseases responsible for a high percentage of deaths especially among children. So, detection and classification of pneumonia using the non-invasive chest x-ray imaging would have a great advantage of reducing the mortality rates.ResultsThe results showed that the best input image size in this framework was 64 64 based on comparison between different sizes. Using CNN as a deep features extractor and utilizing the 10-fold methodology the propose artificial intelligence framework achieved an accuracy of 94% for SVM and 93.9% for KNN, a sensitivity of 93.33% for SVM and 93.19% for KNN and a specificity of 96.68% for SVM and 96.60% for KNN.ConclusionsIn this study, an artificial intelligence framework has been proposed for the detection and classification of pneumonia based on chest x-ray imaging with different sizes of input images. The proposed methodology used CNN for features extraction that were fed to two different types of classifiers, namely, SVM and KNN; in addition to the SoftMax classifier which is the default CNN classifier. The proposed CNN has been trained, validated, and tested using a large dataset of chest x-ray images contains in total 5852 images.

Download Full-text