Machine Learning Augmented Interpretation of Chest X-rays: A Systematic Review

Machine Learning Augmented Interpretation of Chest X-rays: A Systematic Review

Limitations of the chest X-ray (CXR) have resulted in attempts to create machine learning systems to assist clinicians and improve interpretation accuracy. An understanding of the capabilities and limitations of modern machine learning systems is necessary for clinicians as these tools begin to perm...

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Bibliographic Details
Published in:Diagnostics (Basel) Vol. 13; no. 4; p. 743
Main Authors: Ahmad, Hassan K, Milne, Michael R, Buchlak, Quinlan D, Ektas, Nalan, Sanderson, Georgina, Chamtie, Hadi, Karunasena, Sajith, Chiang, Jason, Holt, Xavier, Tang, Cyril H M, Seah, Jarrel C Y, Bottrell, Georgina, Esmaili, Nazanin, Brotchie, Peter, Jones, Catherine
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 01-02-2023
MDPI
Subjects:
Accuracy
Algorithms
Artificial intelligence
Automation
Bias
Business metrics
chest X-ray
Coronaviruses
COVID-19
Datasets
Deep learning
Health aspects
Literature reviews
Lung cancer
Machine learning
Medical imaging
Pathology
Pediatrics
Pneumonia
Pneumothorax
Radiation
radiology
Systematic Review
Tomography
X-rays
Australia
deep learning
chest X-ray
machine learning
radiology
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Summary:Limitations of the chest X-ray (CXR) have resulted in attempts to create machine learning systems to assist clinicians and improve interpretation accuracy. An understanding of the capabilities and limitations of modern machine learning systems is necessary for clinicians as these tools begin to permeate practice. This systematic review aimed to provide an overview of machine learning applications designed to facilitate CXR interpretation. A systematic search strategy was executed to identify research into machine learning algorithms capable of detecting >2 radiographic findings on CXRs published between January 2020 and September 2022. Model details and study characteristics, including risk of bias and quality, were summarized. Initially, 2248 articles were retrieved, with 46 included in the final review. Published models demonstrated strong standalone performance and were typically as accurate, or more accurate, than radiologists or non-radiologist clinicians. Multiple studies demonstrated an improvement in the clinical finding classification performance of clinicians when models acted as a diagnostic assistance device. Device performance was compared with that of clinicians in 30% of studies, while effects on clinical perception and diagnosis were evaluated in 19%. Only one study was prospectively run. On average, 128,662 images were used to train and validate models. Most classified less than eight clinical findings, while the three most comprehensive models classified 54, 72, and 124 findings. This review suggests that machine learning devices designed to facilitate CXR interpretation perform strongly, improve the detection performance of clinicians, and improve the efficiency of radiology workflow. Several limitations were identified, and clinician involvement and expertise will be key to driving the safe implementation of quality CXR machine learning systems.
Bibliography:ObjectType-Article-2
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ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics13040743