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Soares TR, Oliveira RDD, Liu YE, Santos ADS, Santos PCPD, Monte LRS, Oliveira LMD, Park CM, Hwang EJ, Andrews JR, Croda J. Evaluation of chest X-ray with automated interpretation algorithms for mass tuberculosis screening in prisons: a cross-sectional study. Lancet Reg Health Am 2023; 17:100388. [PMID: 36776567 PMCID: PMC9904090 DOI: 10.1016/j.lana.2022.100388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/28/2022] [Accepted: 10/18/2022] [Indexed: 06/18/2023]
Abstract
Background The World Health Organization (WHO) recommends systematic tuberculosis (TB) screening in prisons. Evidence is lacking for accurate and scalable screening approaches in this setting. We aimed to assess the accuracy of artificial intelligence-based chest x-ray interpretation algorithms for TB screening in prisons. Methods We performed prospective TB screening in three male prisons in Brazil from October 2017 to December 2019. We administered a standardized questionnaire, performed a chest x-ray in a mobile unit, and collected sputum for confirmatory testing using Xpert MTB/RIF and culture. We evaluated x-ray images using three algorithms (CAD4TB version 6, Lunit version 3.1.0.0 and qXR version 3) and compared their accuracy. We utilized multivariable logistic regression to assess the effect of demographic and clinical characteristics on algorithm accuracy. Finally, we investigated the relationship between abnormality scores and Xpert semi-quantitative results. Findings Among 2075 incarcerated individuals, 259 (12.5%) had confirmed TB. All three algorithms performed similarly overall with area under the receiver operating characteristic curve (AUC) of 0.88-0.91. At 90% sensitivity, only LunitTB and qXR met the WHO Target Product Profile requirements for a triage test, with specificity of 84% and 74%, respectively. All algorithms had variable performance by age, prior TB, smoking, and presence of TB symptoms. LunitTB was the most robust to this heterogeneity but nonetheless failed to meet the TPP for individuals with previous TB. Abnormality scores of all three algorithms were significantly correlated with sputum bacillary load. Interpretation Automated x-ray interpretation algorithms can be an effective triage tool for TB screening in prisons. However, their specificity is insufficient in individuals with previous TB. Funding This study was supported by the US National Institutes of Health (grant numbers R01 AI130058 and R01 AI149620) and the State Secretary of Health of Mato Grosso do Sul.
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Affiliation(s)
- Thiego Ramon Soares
- Faculty of Health Sciences of Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Roberto Dias de Oliveira
- Faculty of Health Sciences of Federal University of Grande Dourados, Dourados, MS, Brazil
- Nursing School, State University of Mato Grosso do Sul, Dourados, MS, Brazil
| | - Yiran E. Liu
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Andrea da Silva Santos
- Faculty of Health Sciences of Federal University of Grande Dourados, Dourados, MS, Brazil
| | | | | | | | - Chang Min Park
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Eui Jin Hwang
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Jason R. Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Julio Croda
- Oswaldo Cruz Foundation, Campo Grande, MS, Brazil
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, United States of America
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
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Cardoso Portela NL, De Oliveira Pedrosa A, Santos Cunha JD, Soares Monte LR, Silva Gomes RN, Campêlo Lago E. Burnout syndrome in nursing professionals from urgency and emergency services. ACTA ACUST UNITED AC 2015. [DOI: 10.9789/2175-5361.2015.v7i3.2749-2760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objetivo: Analisar como os estudos científicos descrevem a síndrome de Burnout em profissionais de enfermagem de serviços de urgência e emergência. Métodos: Revisão integrativa de literatura realizada através das bases de dados BDENF, IBECS, LILACS, MEDLINE e SciELO, por meio dos descritores: esgotamento profissional and enfermagem. Das 3087 publicações selecionadas pelos descritores, apenas 11 artigos atenderam os critérios de inclusão e exclusão. Resultados: Dentre os artigos selecionados, 07 tratavam do estresse; 04 falavam da qualidade de vida e lazer; 01 abordava sobre os sintomas somáticos associados ao Burnout e 03 detalhavam sobre a síndrome de Burnout, abordando os fatores preditores e as dimensões sintomatológicas de acordo com o Maslach Burnout Inventory. Conclusão: Esse estudo é importante para que população, profissionais e gestores adquiram conhecimento acerca da síndrome, podendo contribuir para o desenvolvimento de estratégias de enfrentamento, que irão minimizar os riscos de desencadeamento do Burnout. Descritores: Esgotamento profissional, Enfermagem, Síndrome.
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