Can artificial intelligence augment COVID-19 screening accuracy?

  • Mei X & al.
  • Nat Med
  • 19/05/2020

  • Liz Scherer
  • Clinical Essentials
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Takeaway

  • Artificial intelligence (AI) potentially boosts rapidity and screening accuracy for COVID-19 patients who test positive by RT-PCR but have normal CT findings.

Why this matters

  • Augmenting chest CT and clinical information with AI may accelerate COVID-19 screening and diagnosis, especially when testing modalities are unavailable.

Key results

  • 905 patients had chest CT scans.
  • 46.3% (419) tested SARS-CoV-2-positive and 53.7% (486) tested negative by RT-PCR/next-generation sequencing.
    • Negatives confirmed by 2+ RT-PCR tests and clinical observation.
  • Clinical factors: age, exposure history, fever/cough/cough with sputum/white blood cell counts.
  • Joint AI model using clinical data and CT imaging outperformed models using either alone.
  • Joint model vs a senior thoracic radiologist using CT+clinical data (95% CIs):
    • Sensitivity: 84.3% (77.1%-90.0%) AI vs  74.6% (66.4%-81.7%) human.
    • Specificity: 82.8% (75.6%-88.5%) AI vs 93.8% (88.5%-97.1%) human.
    • Area under the curve: 0.92 (0.887-0.948) vs 0.84 (0.800-0.884) human.
  • Test set: 25 patients with COVID-19 and normal chest CT per radiologists at presentation.
    • Deep-learning AI model identified 52% (13/25) scans as COVID-19-positive.
    • Clinical model classified 64% (16/25) as COVID-19-positive.
    • Joint model identified 68% (17/25) as COVID-19-positive.
    • Senior thoracic radiologist, radiologist fellow identified 0% (0/25) as positive.

Study design

  • Evaluation of AI model to augment early detection of SARS-CoV-2 infection.
  • Funding: None disclosed.

Limitations

  • Small numbers.
  • Bias toward patients with COVID-19.