BACKGROUND: Clinicians in countries with high tuberculosis (TB) prevalence often treat pleural TB based on clinical grounds, as the availability and sensitivity of diagnostic tests are poor. OBJECTIVE: To evaluate the role of artificial neural networks (ANN) as an aid for the non-invasive diagnosis of pleural TB. These tools can be used in simple computer devices (tablets) without remote internet connection. METHODS: The clinical history and human immunodeficiency virus (HIV) status of 137 patients were prospectively entered in a database. Both non-linear ANN and the linear Fisher discriminant were used to calculate performance indexes based on clinical grounds. The same procedure was performed including pleural fluid test results (smear, culture, adenosine deaminase, serology and nucleic acid amplification test). The gold standard was any positive test for TB. RESULTS: In pre-test modelling, the neural model reached >90% accuracy (Fisher discriminant 74.5%). Under pre-test conditions, ANN had better accuracy compared to each test considered separately. CONCLUSIONS: ANN are highly reliable for diagnosing pleural TB based on clinical grounds and HIV status only, and are useful even in remote conditions lacking access to sophisticated medical or computer infrastructure. In other better-equipped scenarios, these tools should be evaluated as substitutes for thoracocentesis and pleural biopsy.
BACKGROUND: Clinicians in countries with high tuberculosis (TB) prevalence often treat pleural TB based on clinical grounds, as the availability and sensitivity of diagnostic tests are poor. OBJECTIVE: To evaluate the role of artificial neural networks (ANN) as an aid for the non-invasive diagnosis of pleural TB. These tools can be used in simple computer devices (tablets) without remote internet connection. METHODS: The clinical history and human immunodeficiency virus (HIV) status of 137 patients were prospectively entered in a database. Both non-linear ANN and the linear Fisher discriminant were used to calculate performance indexes based on clinical grounds. The same procedure was performed including pleural fluid test results (smear, culture, adenosine deaminase, serology and nucleic acid amplification test). The gold standard was any positive test for TB. RESULTS: In pre-test modelling, the neural model reached >90% accuracy (Fisher discriminant 74.5%). Under pre-test conditions, ANN had better accuracy compared to each test considered separately. CONCLUSIONS: ANN are highly reliable for diagnosing pleural TB based on clinical grounds and HIV status only, and are useful even in remote conditions lacking access to sophisticated medical or computer infrastructure. In other better-equipped scenarios, these tools should be evaluated as substitutes for thoracocentesis and pleural biopsy.
Authors: Fábio S Aguiar; Rodrigo C Torres; João V F Pinto; Afrânio L Kritski; José M Seixas; Fernanda C Q Mello Journal: Med Biol Eng Comput Date: 2016-03-25 Impact factor: 2.602
Authors: Riddhi Doshi; Dennis Falzon; Bruce V Thomas; Zelalem Temesgen; Lal Sadasivan; Giovanni Battista Migliori; Mario Raviglione Journal: ERJ Open Res Date: 2017-06-21
Authors: Miriam Harris; Amy Qi; Luke Jeagal; Nazi Torabi; Dick Menzies; Alexei Korobitsyn; Madhukar Pai; Ruvandhi R Nathavitharana; Faiz Ahmad Khan Journal: PLoS One Date: 2019-09-03 Impact factor: 3.240