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Grant support

The authors acknowledge the support of Ministerio de Ciencia e Innovacion, Agencia Estatal de Investigacion (grant PDC2022-133865-I00) , cofinanced by the European Regional Development Fund (ERDF) , "A way of making Europe," and from the H2020-MSCA-RISE-2018 INNOVA4TB (EU) project (ID 823854) and the ADVANCETB Cost Action (EU) project (ID CA21164) . DCM's PhD fellowship is supported by Universidad Politecnica de Madrid. The telemedicine platform will support the STool4TB project funded by EDCTP2 (grant number RIA2018D-2511) and the nested TITANA ancillary study. We thank the collaborators from this project for their fruitful discussions and feedback.

Analysis of institutional authors

Gomez-Valverde, Juan JCorresponding AuthorGarcia Delgado, LaraAuthorCapellan-Martin, DanielAuthorLedesma-Carbayo, Maria JAuthor

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Chest X-Ray-Based Telemedicine Platform for Pediatric Tuberculosis Diagnosis in Low-Resource Settings: Development and Validation Study

Publicated to:Jmir Pediatrics And Parenting. 7 e51743- - 2024-01-01 7(), DOI: 10.2196/51743

Authors: Gomez-Valverde, Juan J; Sanchez-Jacob, Ramon; Ribo, Jose Luis; Schaaf, H Simon; Delgado, Lara Garcia; Hernanz-Lobo, Alicia; Capellan-Martin, Daniel; Lancharro, Angel; Augusto, Orvalho; Garcia-Basteiro, Alberto L; Santiago-Garcia, Begona; Lopez-Varela, Elisa; Ledesma-Carbayo, Maria J

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Abstract

Background: Tuberculosis (TB) remains a major cause of morbidity and death worldwide, with a significant impact on children, especially those under the age of 5 years. The complex diagnosis of pediatric TB, compounded by limited access to more accurate diagnostic tests, underscores the need for improved tools to enhance diagnosis and care in resource-limited settings. Objective: This study aims to present a telemedicine web platform, BITScreen PTB (Biomedical Image Technologies Screen for Pediatric Tuberculosis), aimed at improving the evaluation of pulmonary TB in children based on digital chest x-ray (CXR) imaging and clinical information in resource-limited settings. Methods: The platform was evaluated by 3 independent expert readers through a retrospective assessment of a data set with 218 imaging examinations of children under 3 years of age, selected from a previous study performed in Mozambique. The key aspects assessed were the usability through a standardized questionnaire, the time needed to complete the assessment through the platform, the performance of the readers to identify TB cases based on the CXR, the association between the TB features identified in the CXRs and the initial diagnostic classification, and the interreader agreement of the global assessment and the radiological findings. Results: The platform's usability and user satisfaction were evaluated using a questionnaire, which received an average rating of 4.4 (SD 0.59) out of 5. The average examination completion time ranged from 35 to 110 seconds. In addition, the study on CXR showed low sensitivity (16.3%-28.2%) but high specificity (91.1%-98.2%) in the assessment of the consensus case definition of pediatric TB using the platform. The CXR finding having a stronger association with the initial diagnostic classification was air space opacification (chi(21)>20.38, P

Keywords

AccuracChest radiographChildrenClassificationClinical case definitionsConsensusIntrathoracic tuberculosisLow-resource settingLow-resource settingsPediatric tuberculosisScreeningTelehealthTelemedicineTuberculosisUsability

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Jmir Pediatrics And Parenting due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2024 there are still no calculated indicators, but in 2023, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category Pediatrics, Perinatology and Child Health.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2025-05-31:

  • Scopus: 1

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-05-31:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 21.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 20 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 2.
  • The number of mentions on the social network X (formerly Twitter): 3 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Mozambique; South African Republic; United States of America.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (GOMEZ VALVERDE, JUAN JOSE) and Last Author (LEDESMA CARBAYO, MARIA JESUS).

the author responsible for correspondence tasks has been GOMEZ VALVERDE, JUAN JOSE.