Diagnostic accuracy of computer aided reading of chest x-ray in screening for pulmonary tuberculosis in comparison with Gene-Xpert

Background & Objectives: Pakistan ranked fifth amongst 22 high-burden Tuberculosis countries, and it is an epidemic in Pakistan, hence screening is performed nationally, as part of the ambitious ZERO TB drive. Our objective was to assess the diagnostic accuracy of Computer Aided Detection (CAD4TB) software on chest Xray in screening for pulmonary tuberculosis in comparison with gene-Xpert. Methods: The study was conducted by Radiology Department Lady Reading Hospital Peshawar in affiliation with Indus Hospital network over a period of one year. Screening was done by using mobile Xray unit equipped with CAD4TB software with scoring system. All of those having score of more than 70 and few selected cases with strong clinical suspicion but score of less than 70 were referred to dedicated TB clinic for Gene-Xpert analysis. Results: Among 26,997 individuals screened, 2617 (9.7%) individuals were found presumptive for pulmonary TB. Sputum samples for Gene-Xpert were obtained in 2100 (80.24%) individuals, out of which 1825 (86.9%) were presumptive for pulmonary TB on CAD4TB only. Gene-Xpert was positive in 159 (8.7%) patients and negative in 1,666(91.3%). Sensitivity and specificity of CAD4TB and symptomatology with threshold score of ≥70 was 83.2% and 12.7% respectively keeping Gene-Xpert as gold standard. Conclusion: Combination of chest X-ray analysis by CAD4TB and symptomatology is of immense value to screen a large population at risk in a developing high burden country. It is significantly a more effective tool for screening and early diagnosis of TB in individuals, who would otherwise go undiagnosed. Abbreviations: TB = Tuberculosis, WHO = World Health Organization, CAD4TB = Computer aided detection for tuberculosis, CXR = Chest X-Ray, CAR = Computer aided reading. doi: https://doi.org/10.12669/pjms.38.1.4531 How to cite this:Nishtar T, Burki S, Ahmad FS, Ahmad T. Diagnostic accuracy of computer aided reading of chest x-ray in screening for pulmonary tuberculosis in comparison with Gene-Xpert. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4531 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Dyslexic Readers Improve without Training When Using a Computer-Guided Reading Strategy

Background: Flawless reading presupposes the ability to simultaneously recognize a sequence of letters, to fixate words at a given location for a given time, to exert eye movements of a given amplitude, and to retrieve phonems rapidly from memory. Poor reading performance may be due to an impairment of at least one of these abilities. Objectives: It was investigated whether reading performance of dyslexic children can be improved by changing the reading strategy without any previous training. Methods: 60 dyslexic German children read a text without and with the help of a computer. A tailored computer program subdivided the text into segments that consisted of no more letters than the children could simultaneously recognize, indicated the location in the segments to which the gaze should be directed, indicated how long the gaze should be directed to each segment, which reading saccades the children should execute, and when the children should pronounce the segments. The computer aided reading was not preceded by any training. Results: It was shown that the rate of reading mistakes dropped immediately by 69.97% if a computer determined the reading process. Computer aided reading reached the highest effect size of Cohen d = 2.649. Conclusions: The results show which abilities are indispensable for reading, that the impairment of at least one of the abilities leads to reading deficiencies that are diagnosed as dyslexia, and that a computer-guided, altered reading strategy immediately reduces the rate of reading mistakes. There was no evidence that dyslexia is due to a lack of eye movement control or reduced visual attention.