Annals of Clinical Epidemiology
Online ISSN : 2434-4338

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Development and external validation of a deep learning-based computed tomography classification system for COVID-19
Yuki KataokaTomohisa BabaTatsuyoshi IkenoueYoshinori MatsuokaJunichi MatsumotoJunji KumasawaKentaro TochitaniHiraku FunakoshiTomohiro HosodaAiko KugimiyaMichinori ShiranoFumiko HamabeSachiyo IwataYoshiro KitamuraTsubasa GotoTomohiro HandaShoji KidoShingo FukumaNoriyuki TomiyamaToyohiro HiraiTakashi OguraJapan COVID-19 AI team
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JOURNAL OPEN ACCESS Advance online publication

Article ID: 22014


Background: We aimed to develop and externally validate a novel machine learning model that can classify CT image findings as positive or negative for SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR).

Methods: We used 2,928 images from a wide variety of case-control type data sources for the development and internal validation of the machine learning model. A total of 633 COVID-19 cases and 2,295 non-COVID-19 cases were included in the study. We randomly divided cases into training and tuning sets at a ratio of 8:2. For external validation, we used 893 images from 740 consecutive patients at 11 acute care hospitals suspected of having COVID-19 at the time of diagnosis. The dataset included 343 COVID-19 patients. The reference standard was RT-PCR.

Results: In external validation, the sensitivity and specificity of the model were 0.869 and 0.432, at the low-level cutoff, 0.724 and 0.721, at the high-level cutoff. Area under the receiver operating characteristic was 0.76.

Conclusions: Our machine learning model exhibited a high sensitivity in external validation datasets and may assist physicians to rule out COVID-19 diagnosis in a timely manner at emergency departments. Further studies are warranted to improve model specificity.

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