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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.

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

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

Autores: 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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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

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