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Abstract, Results.","title":"Diagnostic Accuracy of Computer-Aided Detection During Active Case Finding for Pulmonary Tuberculosis in Africa: A Systematic Review and Meta-analysis","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10849117/","date":"2024-01-17","written_by":"independent","quote":"We found a high risk of bias and applicability concerns across all studies.","supports_benefit":false}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"sources[].upstream_sources":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"strategic_assessments[]":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"strategic assessments"},"summary":{"state":"value_present","value":{"kind":"record_fields","fields":{"summary":"Pooling five African studies of 101,060 people, researchers found that CAD software reading chest X-rays had sensitivity 0.87 and specificity 0.74, just below WHO's target for screening.","account":"Alex Scott and colleagues at the University of Cape Town Lung Institute and the South African Medical Research Council reviewed computer-aided detection of TB in Africa. They sought studies of active case finding published from January 2012 to February 2023 that tested the software against sputum culture or nucleic acid tests. Five studies from Kenya, South Africa and Zambia qualified, with 101,060 participants and 834 people with TB. All used CAD4TB, and one also tested qXR. Pooled sensitivity was 0.87 and specificity 0.74, just below WHO's target of at least 0.90 and 0.70 for a screening test. At 1% prevalence, 9 of every 10 people with TB would be flagged, and 257 of 990 without TB would be sent for testing. The authors found a high risk of bias in all five studies, and three set their thresholds after analysis. 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