Independent evaluation of 12 AI solutions for the detection of TB

There have been few independent evaluations of computer-aided detection (CAD) software for
tuberculosis (TB) screening, despite the rapidly expanding array of available CAD solutions. We
developed a test library of chest X-ray (CXR) images which was blindly re-read by two TB clinicians
with different levels of experience and then processed by 12 CAD software solutions. Using Xpert
MTB/RIF results as the reference standard, we compared the performance characteristics of each
CAD software against both an Expert and Intermediate Reader, using cut-of thresholds which were
selected to match the sensitivity of each human reader. Six CAD systems performed on par with the
Expert Reader (Qure.ai, DeepTek, Delft Imaging, JF Healthcare, OXIPIT, and Lunit) and one additional
software (Infervision) performed on par with the Intermediate Reader only. Qure.ai, Delft Imaging
and Lunit were the only software to perform significantly better than the Intermediate Reader. The
majority of these CAD software showed significantly lower performance among participants with
a past history of TB. The radiography equipment used to capture the CXR image was also shown to
affect performance for some CAD software. TB program implementers now have a wide selection of
quality CAD software solutions to utilize in their CXR screening initiatives.

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