Testing the performance, adequacy, and applicability of an artificial intelligence model for pediatric pneumonia diagnosis.

Journal: Computer methods and programs in biomedicine
Published Date:

Abstract

BACKGROUND: Community-acquired Pneumonia (CAP) is a common childhood infectious disease. Deep learning models show promise in X-ray interpretation and diagnosis, but their validation should be extended due to limitations in the current validation workflow. To extend the standard validation workflow we propose doing a pilot test with the next characteristics. First, the assumption of perfect ground truth (100% sensitive and specific) is unrealistic, as high intra and inter-observer variability have been reported. To address this, we propose using Bayesian latent class models (BLCA) to estimate accuracy during the pilot. Additionally, assessing only the performance of a model without considering its applicability and acceptance by physicians is insufficient if we hope to integrate AI systems into day-to-day clinical practice. Therefore, we propose employing explainable artificial intelligence (XAI) methods during the pilot test to involve physicians and evaluate how well a Deep Learning model is accepted and how helpful it is for routine decisions as well as analyze its limitations by assessing the etiology. This study aims to apply the proposed pilot to test a deep Convolutional Neural Network (CNN)-based model for identifying consolidation in pediatric chest-X-ray (CXR) images already validated using the standard workflow.

Authors

  • Sara Domínguez-Rodríguez
    Pediatric Research and Clinical Trials Unit (UPIC). Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain.
  • Helena Liz-López
    Computer Systems Engineering Department, Universidad Politécnica de Madrid, Spain.
  • Angel Panizo-LLedot
    Computer Systems Engineering Department, Universidad Politécnica de Madrid, Spain. Electronic address: angel.panizo@upm.es.
  • Álvaro Ballesteros
    Pediatric Research and Clinical Trials Unit (UPIC). Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain.
  • Ron Dagan
    Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
  • David Greenberg
    Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Soroka University Medical Center, Beer-Sheva, Israel.
  • Lourdes Gutiérrez
    Pediatric Research and Clinical Trials Unit (UPIC). Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain.
  • Pablo Rojo
    Pediatric Research and Clinical Trials Unit (UPIC). Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain; Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain.
  • Enrique Otheo
    Hospital Universitario Ramón y Cajal. Pediatrics Department, Madrid, Spain.
  • Juan Carlos Galán
    Servicio de Microbiología, Hospital Universitario Ramon y Cajal, Madrid, Spain.
  • Sara Villanueva
    Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain.
  • Sonsoles García
    Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain.
  • Pablo Mosquera
    Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain.
  • Alfredo Tagarro
    Pediatric Research and Clinical Trials Unit (UPIC). Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain; Fundación para la Investigación e Innovación Biomédica del Hospital Universitario Infanta Sofía y Hospital Universitario del Henares. Madrid, Spain; Pediatrics Research Group. Universidad Europea de Madrid. Pediatrics, Madrid, Spain.
  • Cinta Moraleda
    Pediatric Research and Clinical Trials Unit (UPIC). Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain; Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain.
  • David Camacho
    Computer Science Department, Universidad Autónoma de Madrid, Spain.