Clinical and Economic Evaluation of a Real-Time Chest X-Ray Computer-Aided Detection System for Misplaced Endotracheal and Nasogastric Tubes and Pneumothorax in Emergency and Critical Care Settings: Protocol for a Cluster Randomized Controlled Trial.

Journal: JMIR research protocols
Published Date: Aug 20, 2025

Abstract

BACKGROUND: Advancements in artificial intelligence (AI) have driven substantial breakthroughs in computer-aided detection (CAD) for chest x-ray (CXR) imaging. The National Taiwan University Hospital research team previously developed an AI-based emergency CXR system (Capstone project), which led to the creation of a CXR module. This CXR module has an established model supported by extensive research and is ready for application in clinical trials without requiring additional model training. This study will use 3 submodules of the system: detection of misplaced endotracheal tubes, detection of misplaced nasogastric tubes, and identification of pneumothorax.

Authors

  • Chu-Lin Tsai
    National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan.
  • Teresa Cheng-Chieh Chu
    Integrative Medical Data Center, Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan.
  • Chih-Hung Wang
    National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan.
  • Wei-Tien Chang
    Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
  • Min-Shan Tsai
    Department of Emergency Medicine, National Taiwan University, 100 Taipei, Taiwan.
  • Shih-Chi Ku
    Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
  • Yen-Hung Lin
    Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan (Y.H.L.).
  • Hao-Chih Tai
    Department of Surgery, National Taiwan University Hospital, No.1, Changde St., Zhongzheng Dist., Taipei, 10048, Taiwan, Republic of China.
  • Shuenn-Wen Kuo
    Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
  • Kuo-Chuan Wang
    Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
  • Anne Chao
    Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
  • Sung-Chun Tang
    Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
  • Wei-Lun Liu
    Division of Critical Care Medicine, Department of Emergency and Critical Care Medicine, Fu Jen Catholic University Hopsital, New Taipei, Taiwan.
  • Ming-Han Tsai
    Department of Critical Care Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan.
  • Ting-Ann Wang
    Integrative Medical Data Center, Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan.
  • Shu-Lin Chuang
    Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan.
  • Yi-Chia Lee
    Integrative Medical Data Center, Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan.
  • Lu-Cheng Kuo
    Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
  • Chiuan-Jung Chen
    Information Technology Office, National Taiwan University Hospital, Taipei, Taiwan.
  • Jia-Horng Kao
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
  • Weichung Wang
    Graduate Program of Data Science, National Taiwan University and Academia Sinica, Taipei, Taiwan.
  • Chien-Hua Huang
    Department of Emergency Medicine, National Taiwan University, 100 Taipei, Taiwan.

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