1
|
Tenda ED, Yunus RE, Zulkarnaen B, Yugo MR, Pitoyo CW, Asaf MM, Islamiyati TN, Pujitresnani A, Setiadharma A, Henrina J, Rumende CM, Wulani V, Harimurti K, Lydia A, Shatri H, Soewondo P, Yusuf PA. Comparison of the Discrimination Performance of AI Scoring and the Brixia Score in Predicting COVID-19 Severity on Chest X-Ray Imaging: Diagnostic Accuracy Study. JMIR Form Res 2024; 8:e46817. [PMID: 38451633 PMCID: PMC10958333 DOI: 10.2196/46817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 09/28/2023] [Accepted: 12/29/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND The artificial intelligence (AI) analysis of chest x-rays can increase the precision of binary COVID-19 diagnosis. However, it is unknown if AI-based chest x-rays can predict who will develop severe COVID-19, especially in low- and middle-income countries. OBJECTIVE The study aims to compare the performance of human radiologist Brixia scores versus 2 AI scoring systems in predicting the severity of COVID-19 pneumonia. METHODS We performed a cross-sectional study of 300 patients suspected with and with confirmed COVID-19 infection in Jakarta, Indonesia. A total of 2 AI scores were generated using CAD4COVID x-ray software. RESULTS The AI probability score had slightly lower discrimination (area under the curve [AUC] 0.787, 95% CI 0.722-0.852). The AI score for the affected lung area (AUC 0.857, 95% CI 0.809-0.905) was almost as good as the human Brixia score (AUC 0.863, 95% CI 0.818-0.908). CONCLUSIONS The AI score for the affected lung area and the human radiologist Brixia score had similar and good discrimination performance in predicting COVID-19 severity. Our study demonstrated that using AI-based diagnostic tools is possible, even in low-resource settings. However, before it is widely adopted in daily practice, more studies with a larger scale and that are prospective in nature are needed to confirm our findings.
Collapse
Affiliation(s)
- Eric Daniel Tenda
- Department of Internal Medicine, Pulmonology and Critical Care Division, Faculty of Medicine Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Reyhan Eddy Yunus
- Department of Radiology, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Benny Zulkarnaen
- Department of Radiology, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Muhammad Reynalzi Yugo
- Department of Radiology, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Ceva Wicaksono Pitoyo
- Department of Internal Medicine, Pulmonology and Critical Care Division, Faculty of Medicine Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Moses Mazmur Asaf
- Department of Radiology, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Tiara Nur Islamiyati
- Department of Internal Medicine, Pulmonology and Critical Care Division, Faculty of Medicine Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Arierta Pujitresnani
- Department of Medical Physiology and Biophysics/ Medical Technology Cluster IMERI, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Andry Setiadharma
- Department of Internal Medicine, Pulmonology and Critical Care Division, Faculty of Medicine Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Joshua Henrina
- Department of Internal Medicine, Pulmonology and Critical Care Division, Faculty of Medicine Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Cleopas Martin Rumende
- Department of Internal Medicine, Pulmonology and Critical Care Division, Faculty of Medicine Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Vally Wulani
- Department of Radiology, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Kuntjoro Harimurti
- Department of Internal Medicine, Geriatric Division, Faculty of Medicine Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Aida Lydia
- Department of Internal Medicine, Nephrology and Hypertension Division, Faculty of Medicine Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Hamzah Shatri
- Department of Internal Medicine, Psychosomatic Division, Faculty of Medicine Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Pradana Soewondo
- Department of Internal Medicine, Endocrinology - Metabolism - Diabetes division, Faculty of Medicine Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Universitas Indonesia, Jakarta, Indonesia
| | - Prasandhya Astagiri Yusuf
- Department of Medical Physiology and Biophysics/ Medical Technology Cluster IMERI, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| |
Collapse
|
2
|
Tenda ED, Henrina J, Setiadharma A, Aristy DJ, Romadhon PZ, Thahadian HF, Mahdi BA, Adhikara IM, Marfiani E, Suryantoro SD, Yunus RE, Yusuf PA. Derivation and validation of novel integrated inpatient mortality prediction score for COVID-19 (IMPACT) using clinical, laboratory, and AI-processed radiological parameter upon admission: a multicentre study. Sci Rep 2024; 14:2149. [PMID: 38272920 PMCID: PMC10810804 DOI: 10.1038/s41598-023-50564-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/21/2023] [Indexed: 01/27/2024] Open
Abstract
Limited studies explore the use of AI for COVID-19 prognostication. This study investigates the relationship between AI-aided radiographic parameters, clinical and laboratory data, and mortality in hospitalized COVID-19 patients. We conducted a multicentre retrospective study. The derivation and validation cohort comprised of 512 and 137 confirmed COVID-19 patients, respectively. Variable selection for constructing an in-hospital mortality scoring model was performed using the least absolute shrinkage and selection operator, followed by logistic regression. The accuracy of the scoring model was assessed using the area under the receiver operating characteristic curve. The final model included eight variables: anosmia (OR: 0.280; 95%CI 0.095-0.826), dyspnoea (OR: 1.684; 95%CI 1.049-2.705), loss of consciousness (OR: 4.593; 95%CI 1.702-12.396), mean arterial pressure (OR: 0.928; 95%CI 0.900-0.957), peripheral oxygen saturation (OR: 0.981; 95%CI 0.967-0.996), neutrophil % (OR: 1.034; 95%CI 1.013-1.055), serum urea (OR: 1.018; 95%CI 1.010-1.026), affected lung area score (OR: 1.026; 95%CI 1.014-1.038). The Integrated Inpatient Mortality Prediction Score for COVID-19 (IMPACT) demonstrated a predictive value of 0.815 (95% CI 0.774-0.856) in the derivation cohort. Internal validation resulted in an AUROC of 0.770 (95% CI 0.661-0.879). Our study provides valuable evidence of the real-world application of AI in clinical settings. However, it is imperative to conduct prospective validation of our findings, preferably utilizing a control group and extending the application to broader populations.
Collapse
Affiliation(s)
- Eric Daniel Tenda
- Pulmonology and Critical Care Medicine Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Pangeran Diponegoro No. 71, RW. 5, Kenari, Kec. Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota Jakarta, 10430, Indonesia.
- Medical Technology Cluster of Indonesian Medical Research Institute (IMERI), Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Joshua Henrina
- Pulmonology and Critical Care Medicine Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Pangeran Diponegoro No. 71, RW. 5, Kenari, Kec. Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota Jakarta, 10430, Indonesia
| | - Andry Setiadharma
- Pulmonology and Critical Care Medicine Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Pangeran Diponegoro No. 71, RW. 5, Kenari, Kec. Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota Jakarta, 10430, Indonesia
| | - Dahliana Jessica Aristy
- Pulmonology and Critical Care Medicine Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jl. Pangeran Diponegoro No. 71, RW. 5, Kenari, Kec. Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota Jakarta, 10430, Indonesia
| | - Pradana Zaky Romadhon
- Hematology and Medical Oncology, Department of Internal Medicine, Universitas Airlangga Academic Hospital, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
| | - Harik Firman Thahadian
- Pulmonology and Critical Care Medicine Division, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Bagus Aulia Mahdi
- Department of Internal Medicine, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
| | - Imam Manggalya Adhikara
- Cardiology Division, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Erika Marfiani
- Pulmonology and Critical Care Medicine Division, Department of Internal Medicine, Faculty of Medicine Universitas Airlangga, Universitas Airlangga Academic Hospital, Surabaya, Indonesia
| | - Satriyo Dwi Suryantoro
- Nephrology Division, Department of Internal Medicine, Faculty of Medicine Universitas Airlangga, Universitas Airlangga Academic Hospital, Surabaya, Indonesia
| | - Reyhan Eddy Yunus
- Medical Technology Cluster of Indonesian Medical Research Institute (IMERI), Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Department of Radiology, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Prasandhya Astagiri Yusuf
- Medical Technology Cluster of Indonesian Medical Research Institute (IMERI), Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Department of Medical Physiology and Biophysics, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| |
Collapse
|