Common pitfalls and recommendations for using machine learning to detect and prognosticate for COVID-19 using chest radiographs and CT scans (original) (raw)
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Machine Learning Models for Image-Based Diagnosis and Prognosis of COVID-19: Systematic Review
JMIR Medical Informatics, 2021
Background Accurate and timely diagnosis and effective prognosis of the disease is important to provide the best possible care for patients with COVID-19 and reduce the burden on the health care system. Machine learning methods can play a vital role in the diagnosis of COVID-19 by processing chest x-ray images. Objective The aim of this study is to summarize information on the use of intelligent models for the diagnosis and prognosis of COVID-19 to help with early and timely diagnosis, minimize prolonged diagnosis, and improve overall health care. Methods A systematic search of databases, including PubMed, Web of Science, IEEE, ProQuest, Scopus, bioRxiv, and medRxiv, was performed for COVID-19–related studies published up to May 24, 2020. This study was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. All original research articles describing the application of image processing for the prediction and diagnosis o...
Machine learning approaches for COVID-19 detection from chest X-ray imaging: A Systematic Review
arXiv (Cornell University), 2022
There is a necessity to develop affordable, and reliable diagnostic tools, which allow containing the COVID-19 spreading. Machine Learning (ML) algorithms have been proposed to design support decision-making systems to assess chest X-ray images, which have proven to be useful to detect and evaluate disease progression. Many research articles are published around this subject, which makes it difficult to identify the best approaches for future work. This paper presents a systematic review of ML applied to COVID-19 detection using chest X-ray images, aiming to offer a baseline for researchers in terms of methods, architectures, databases, and current limitations.
European Radiology
Objectives While chest radiograph (CXR) is the first-line imaging investigation in patients with respiratory symptoms, differentiating COVID-19 from other respiratory infections on CXR remains challenging. We developed and validated an AI system for COVID-19 detection on presenting CXR. Methods A deep learning model (RadGenX), trained on 168,850 CXRs, was validated on a large international test set of presenting CXRs of symptomatic patients from 9 study sites (US, Italy, and Hong Kong SAR) and 2 public datasets from the US and Europe. Performance was measured by area under the receiver operator characteristic curve (AUC). Bootstrapped simulations were performed to assess performance across a range of potential COVID-19 disease prevalence values (3.33 to 33.3%). Comparison against international radiologists was performed on an independent test set of 852 cases. Results RadGenX achieved an AUC of 0.89 on 4-fold cross-validation and an AUC of 0.79 (95%CI 0.78-0.80) on an independent test cohort of 5,894 patients. Delong's test showed statistical differences in model performance across patients from different regions (p < 0.01), disease severity (p < 0.001), gender (p < 0.001), and age (p = 0.03). Prevalence simulations showed the negative predictive value increases from 86.1% at 33.3% prevalence, to greater than 98.5% at any prevalence below 4.5%. Compared with radiologists, McNemar's test showed the model has higher sensitivity (p < 0.001) but lower specificity (p < 0.001). Conclusion An AI model that predicts COVID-19 infection on CXR in symptomatic patients was validated on a large international cohort providing valuable context on testing and performance expectations for AI systems that perform COVID-19 prediction on CXR. Key Points • An AI model developed using CXRs to detect COVID-19 was validated in a large multi-center cohort of 5,894 patients from 9 prospectively recruited sites and 2 public datasets. • Differences in AI model performance were seen across region, disease severity, gender, and age. • Prevalence simulations on the international test set demonstrate the model's NPV is greater than 98.5% at any prevalence below 4.5%.
European Radiology Experimental
Background We aimed to train and test a deep learning classifier to support the diagnosis of coronavirus disease 2019 (COVID-19) using chest x-ray (CXR) on a cohort of subjects from two hospitals in Lombardy, Italy. Methods We used for training and validation an ensemble of ten convolutional neural networks (CNNs) with mainly bedside CXRs of 250 COVID-19 and 250 non-COVID-19 subjects from two hospitals (Centres 1 and 2). We then tested such system on bedside CXRs of an independent group of 110 patients (74 COVID-19, 36 non-COVID-19) from one of the two hospitals. A retrospective reading was performed by two radiologists in the absence of any clinical information, with the aim to differentiate COVID-19 from non-COVID-19 patients. Real-time polymerase chain reaction served as the reference standard. Results At 10-fold cross-validation, our deep learning model classified COVID-19 and non-COVID-19 patients with 0.78 sensitivity (95% confidence interval [CI] 0.74–0.81), 0.82 specificity ...
2020
BACKGROUND Most of the mortality resulting from COVID-19 has been associated with severe disease. Effective treatment of severe cases remains a challenge due to the lack of early detection of the infection. OBJECTIVE This study aimed to develop an effective prediction model for COVID-19 severity by combining radiological outcome with clinical biochemical indexes. METHODS A total of 46 patients with COVID-19 (10 severe, 36 nonsevere) were examined. To build the prediction model, a set of 27 severe and 151 nonsevere clinical laboratory records and computerized tomography (CT) records were collected from these patients. We managed to extract specific features from the patients’ CT images by using a recently published convolutional neural network. We also trained a machine learning model combining these features with clinical laboratory results. RESULTS We present a prediction model combining patients’ radiological outcomes with their clinical biochemical indexes to identify severe COVI...
Avicenna Journal of Medical Biochemistry, 2020
Background: In this study, the artificial intelligence (AI) techniques used for the detection of coronavirus disease 2019 (COVID-19) from the chest x-ray were reviewed. Methods: PubMed, arXiv, and Google Scholar were used to search for AI studies. Results: A total of 20 papers were extracted from Google Scholar, 14 from arXiv, and 5 from PubMed. In 17 papers, publicly available datasets and in 3 papers, independent datasets were used. 10 papers disclosed source codes. Nine papers were about creating a novel AI software, 8 papers reported the modification of the existing AI models, and 3 compared the performance of the existing AI software programs. All papers have used deep learning as AI technique. Most papers reported accuracy, specificity, and sensitivity of the models, and also the area under the curve (AUC) for investigation of the model performance for the prediction of COVID-19. Nine papers reported accuracy, sensitivity, and specificity. The number of datasets used in the st...
A survey of machine learning techniques for detecting and diagnosing COVID-19 from imaging
Quantitative Biology
Background: Due to the limited availability and high cost of the reverse transcription-polymerase chain reaction (RT-PCR) test, many studies have proposed machine learning techniques for detecting COVID-19 from medical imaging. The purpose of this study is to systematically review, assess and synthesize research articles that have used different machine learning techniques to detect and diagnose COVID-19 from chest X-ray and CT scan images. Methods: A structured literature search was conducted in the relevant bibliographic databases to ensure that the survey solely centered on reproducible and high-quality research. We selected papers based on our inclusion criteria. Results: In this survey, we reviewed 98 articles that fulfilled our inclusion criteria. We have surveyed a complete pipeline of chest imaging analysis techniques related to COVID-19, including data collection, pre-processing, feature extraction, classification, and visualization. We have considered CT scans and X-rays as both are widely used to describe the latest developments in medical imaging to detect COVID-19. Conclusions: This survey provides researchers with valuable insights into different machine learning techniques and their performance in the detection and diagnosis of COVID-19 from chest imaging. At the end, the challenges and limitations in detecting COVID-19 using machine learning techniques and the future direction of research are discussed.
2021
PurposeTo derive and validate an effective radiomics-based model for differentiation of COVID-19 pneumonia from other lung diseases using a very large cohort of patients.MethodsWe collected 19 private and 5 public datasets, accumulating to 26,307 individual patient images (15,148 COVID-19; 9,657 with other lung diseases e.g. non-COVID-19 pneumonia, lung cancer, pulmonary embolism; 1502 normal cases). Images were automatically segmented using a validated deep learning (DL) model and the results carefully reviewed. Images were first cropped into lung-only region boxes, then resized to 296×216 voxels. Voxel dimensions was resized to 1×1×1mm3 followed by 64-bin discretization. The 108 extracted features included shape, first-order histogram and texture features. Univariate analysis was first performed using simple logistic regression. The thresholds were fixed in the training set and then evaluation performed on the test set. False discovery rate (FDR) correction was applied to the p-va...
A web-based Diagnostic Tool for COVID-19 Using Machine Learning on Chest Radiographs (CXR)
2020
This paper reports the development and web deployment of an inference model for Coronavirus COVID-19 using machine vision on chest radiographs (CXR). The transfer learning from the Residual Network (RESNET-50) was leveraged for model development on CXR images from healthy individuals, bacterial and viral pneumonia, and COVID-19 positives patients. The performance metrics showed an accuracy of 99%, a recall valued of 99.8%, a precision of 99% and an F1 score of 99.8% for COVID-19 inference. The model was further successfully validated on CXR images from an independent repository. The implemented model was deployed with a web graphical user interface for inference (https://medicsinference.onrender.com) for the medical research community; an associated cron job is scheduled to continue the learning process when novel and validated information becomes available.
Machine Learning Applied to COVID-19: A Review of the Initial Pandemic Period
International Journal of Computational Intelligence Systems
Diagnostic and decision-making processes in the 2019 Coronavirus treatment have combined new standards using patient chest images, clinical and laboratory data. This work presents a systematic review aimed at studying the Artificial Intelligence (AI) approaches to the patients’ diagnosis or evolution with Coronavirus 2019. Five electronic databases were searched, from December 2019 to October 2020, considering the beginning of the pandemic when there was no vaccine influencing the exploration of Artificial Intelligence-based techniques. The first search collected 839 papers. Next, the abstracts were reviewed, and 138 remained after the inclusion/exclusion criteria was performed. After thorough reading and review by a second group of reviewers, 64 met the study objectives. These papers were carefully analyzed to identify the AI techniques used to interpret the images, clinical and laboratory data, considering a distribution regarding two variables: (i) diagnosis or outcome and (ii) t...