Departamento de Radiología, Hospital Universitario "Marqués de Valdecilla", Santander, Spain.
Departamento Morfología y Biología Celular, Universidad de Oviedo, Oviedo, Spain.
J Digit Imaging. 2021 Apr;34(2):242-256. doi: 10.1007/s10278-021-00424-7. Epub 2021 Mar 8.
In December 2019, a new coronavirus known as 2019-nCoV emerged in Wuhan, China. The virus has spread globally and the infection was declared pandemic in March 2020. Although most cases of coronavirus disease 2019 (COVID-19) are mild, some of them rapidly develop acute respiratory distress syndrome. In the clinical management, chest X-rays (CXR) are essential, but the evaluation of COVID-19 CXR could be a challenge. In this context, we developed COVID-19 TRAINING, a free Web application for training on the evaluation of COVID-19 CXR. The application included 196 CXR belonging to three categories: non-pathological, pathological compatible with COVID-19, and pathological non-compatible with COVID-19. On the training screen, images were shown to the users and they chose a diagnosis among those three possibilities. At any time, users could finish the training session and be evaluated through the estimation of their diagnostic accuracy values: sensitivity, specificity, predictive values, and global accuracy. Images were hand-labeled by four thoracic radiologists. Average values for sensitivity, specificity, and global accuracy were .72, .64, and .68. Users who achieved better sensitivity registered less specificity (p < .0001) and those with higher specificity decreased their sensitivity (p < .0001). Users who sent more answers achieved better accuracy (p = .0002). The application COVID-19 TRAINING provides a revolutionary tool to learn the necessary skills to evaluate COVID-19 on CXR. Diagnosis training applications could provide a new original manner of evaluation for medical professionals based on their diagnostic accuracy values, and an efficient method to collect valuable data for research purposes.
2019 年 12 月，一种新型冠状病毒在中国武汉出现，被称为 2019-nCoV。该病毒已在全球范围内传播，2020 年 3 月宣布该感染为大流行。虽然大多数 2019 年冠状病毒病（COVID-19）病例为轻症，但其中一些病例迅速发展为急性呼吸窘迫综合征。在临床管理中，胸部 X 射线（CXR）至关重要，但 COVID-19 CXR 的评估可能具有挑战性。在这种情况下，我们开发了 COVID-19 TRAINING，这是一种用于 COVID-19 CXR 评估培训的免费网络应用程序。该应用程序包括 196 张 CXR，分为三类：非病理性、与 COVID-19 相符的病理性和与 COVID-19 不相符的病理性。在培训屏幕上，向用户显示图像，他们在这三种可能性中选择一种诊断。用户随时可以完成培训课程，并通过评估其诊断准确性值（敏感性、特异性、预测值和总准确性）来进行评估。图像由四位胸部放射科医生手动标记。敏感性、特异性和总准确性的平均值分别为.72、.64 和.68。具有更好敏感性的用户特异性较低（p <.0001），特异性较高的用户敏感性降低（p <.0001）。发送更多答案的用户准确性更高（p =.0002）。应用程序 COVID-19 TRAINING 提供了一种革命性的工具，可学习评估 COVID-19 所需的 CXR 技能。诊断培训应用程序可以根据其诊断准确性值为医疗专业人员提供一种新的原始评估方式，并且是收集有价值研究数据的有效方法。
