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In Journal of thoracic imaging

PURPOSE : To evaluate the performance of a deep learning (DL) algorithm for the detection of COVID-19 on chest radiographs (CXR).

MATERIALS AND METHODS : In this retrospective study, a DL model was trained on 112,120 CXR images with 14 labeled classifiers (ChestX-ray14) and fine-tuned using initial CXR on hospital admission of 509 patients, who had undergone COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR). The test set consisted of a CXR on presentation of 248 individuals suspected of COVID-19 pneumonia between February 16 and March 3, 2020 from 4 centers (72 RT-PCR positives and 176 RT-PCR negatives). The CXR were independently reviewed by 3 radiologists and using the DL algorithm. Diagnostic performance was compared with radiologists' performance and was assessed by area under the receiver operating characteristics (AUC).

RESULTS : The median age of the subjects in the test set was 61 (interquartile range: 39 to 79) years (51% male). The DL algorithm achieved an AUC of 0.81, sensitivity of 0.85, and specificity of 0.72 in detecting COVID-19 using RT-PCR as the reference standard. On subgroup analyses, the model achieved an AUC of 0.79, sensitivity of 0.80, and specificity of 0.74 in detecting COVID-19 in patients presented with fever or respiratory systems and an AUC of 0.87, sensitivity of 0.85, and specificity of 0.81 in distinguishing COVID-19 from other forms of pneumonia. The algorithm significantly outperforms human readers (P<0.001 using DeLong test) with higher sensitivity (P=0.01 using McNemar test).

CONCLUSIONS : A DL algorithm (COV19NET) for the detection of COVID-19 on chest radiographs can potentially be an effective tool in triaging patients, particularly in resource-stretched health-care systems.

Chiu Wan Hang Keith, Vardhanabhuti Varut, Poplavskiy Dmytro, Yu Philip Leung Ho, Du Richard, Yap Alistair Yun Hee, Zhang Sailong, Fong Ambrose Ho-Tung, Chin Thomas Wing-Yan, Lee Jonan Chun Yin, Leung Siu Ting, Lo Christine Shing Yen, Lui Macy Mei-Sze, Fang Benjamin Xin Hao, Ng Ming-Yen, Kuo Michael D