Table 2.
Performance of Computer-Aided Detection When Using a Fixed Abnormality Threshold According to Previous Tuberculosis Treatment Status
| Sensitivity (95% CI) |
Specificity (95% CI) |
Positive Likelihood Ratio (95% CI) |
Negative Likelihood Ratio (95% CI) |
|
|---|---|---|---|---|
| Overall | ||||
| ȃCAD4TBb (n = 1884) | 90.3 (86.3–93.4) | 51.2 (48.7–53.7) | 1.8 (1.7–2.0) | .2 (.1–.3) |
| ȃqXRc (n = 1884) | 90.6 (86.7–93.7) | 51.9 (49.4–54.4) | 1.9 (1.8–2.0) | .2 (.1–.3) |
| Previous TB | ||||
| ȃCAD4TB | ||||
| ȃȃAll (n = 452) | 89.3 (78.1–96.0) | 24.0 (19.9–28.5) | 1.2 (1.1–1.3) | .4 (.2–1.0) |
| ȃȃȃSex | ||||
| ȃȃȃȃMale (n = 326) | 91.1 (78.8–97.5) | 17.4 (13.2–22.4) | 1.1 (1.0–1.2) | .5 (.2–1.3) |
| ȃȃȃȃFemale (n = 126) | 81.8 (48.2–97.7) | 40.0 (31.0–49.6) | 1.4 (1.0–1.9) | .5 (.1–1.6) |
| ȃȃȃHIV statusa | ||||
| ȃȃȃȃHIV positive (n = 250) | 87.1 (70.2–96.4) | 28.3 (22.4–34.8) | 1.2 (1.0–1.4) | .5 (.2–1.2) |
| ȃȃȃȃHIV negative (n = 180) | 90.5 (69.6–98.8) | 18.9 (13.1–25.8) | 1.1 (1.0–1.3) | .5 (.1–2.0) |
| ȃqXR | ||||
| ȃȃAll (n = 452) | 94.6 (85.1–98.9) | 22.2 (18.2–26.6) | 1.2 (1.1–1.3) | .2 (.1–.7) |
| ȃȃȃSex | ||||
| ȃȃȃȃMale (n = 326) | 97.8 (88.2–99.2) | 16.4 (12.2–21.2) | 1.2 (1.1–1.25) | .3 (.0–1.0) |
| ȃȃȃȃFemale (n = 126) | 81.8 (48.2–97.7) | 36.5 (27.7–46.0) | 1.3 (.9–1.8) | .5 (.1–1.8) |
| ȃȃHIV statusa | ||||
| ȃȃȃHIV positive (n = 250) | 93.5 (78.6–99.2) | 26.5 (20.8–32.9) | 1.3 (1.1–1.4) | .2 (.1–.9) |
| ȃȃȃHIV negative (n = 180) | 95.2 (76.2–99.9) | 15.7 (10.4–22.3) | 1.1 (1.0–1.3) | .3 (.0–2.1) |
| No previous TB | ||||
| ȃCAD4TB | ||||
| ȃȃAll (n = 1432) | 90.5 (86.1–93.3) | 60.3 (57.4–63.0) | 2.3 (2.1–2.5) | .2 (.1–.2) |
| ȃȃȃSex | ||||
| ȃȃȃȃMale (n = 858) | 91.5 (86.4–95.2) | 52.6 (48.7–56.4) | 1.9 (1.8–2.1) | .2 (.1–.3) |
| ȃȃȃȃFemale (n = 574) | 87.7 (77.2–94.5) | 70.5 (66.4–74.5) | 3.0 (2.5–3.5) | .2 (.1–.3) |
| ȃȃȃHIV statusa | ||||
| ȃȃȃȃHIV positive (n = 452) | 89.5 (81.1–95.1) | 52.7 (47.5–57.9) | 1.9 (1.7–2.2) | .2 (.1–.4) |
| ȃȃȃȃHIV negative (n = 893) | 91.5 (85.7–95.6) | 64.4 (60.9–67.9) | 2.6 (2.3–2.9) | .1 (.1–.2) |
| ȃȃqXR | ||||
| ȃȃAll (n = 1432) | 89.7 (85.1–93.2) | 61.8 (58.9–64.5) | 2.4 (2.2–2.6) | .2 (.1–.2) |
| ȃȃȃSex | ||||
| ȃȃȃȃMale (n = 858) | 91.0 (85.7–94.7) | 53.7 (49.9–57.5) | 2.0 (1.8–2.2) | .2 (.1–.3) |
| ȃȃȃȃFemale (n = 574) | 86.2 (75.3–93.5) | 72.5 (68.4–76.3) | 3.1 (2.6–3.7) | .2 (.1–.4) |
| ȃȃȃHIV statusa | ||||
| ȃȃȃȃHIV positive (n = 452) | 89.5 (81.1–95.1) | 52.5 (47.2–57.7) | 1.9 (1.7–2.1) | .2 (.1–.4) |
| ȃȃȃȃHIV negative (n = 893) | 90.1 (84.0–94.5) | 66.8 (63.3–70.2) | 2.7 (2.4–3.1) | .1 (.1–.2) |
The fixed threshold for each software was determined on the basis of the CAD score that achieved at least 90% sensitivity while optimizing specificity among all study participants. These thresholds were 15 for CAD4TB and 6 for qXR, respectively. Abbreviations: CAD, computer-aided detection; CI, confidence interval; HIV, human immunodeficiency virus; TB, tuberculosis.
There were 109 patients with an unknown HIV status (n = 22 persons with previous TB and n = 87 persons without previous TB).
Delft Imaging Systems, Netherlands.
Qure.ai, India.