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xrAI - Improving Quality and Efficiency in Chest Radiograph Interpretation by Radiologists

xrAI - Improving Quality and Efficiency in Chest Radiograph Interpretation by Radiologists

Status
Withdrawn
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04221100
Enrollment
0
Registered
2020-01-09
Start date
2021-03-31
Completion date
2021-05-31
Last updated
2021-02-23

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Pulmonary Disease

Brief summary

xrAI (pronounced X-ray) serves as a clinical assistance tool for trained clinical professionals who are interpreting chest radiographs. The tool is designed as a quality control and adjunct, limited, clinical decision support tool, and does not replace the role of clinical professionals. It highlights areas on chest radiographs for review by an interpreting clinician. The objective of this study is to utilize machine learning and artificial intelligence algorithms (xrAI) to improve the quality and efficiency in the interpretation of chest radiographs by radiologists. The hypothesis is that the addition of xrAI's analysis will reduce inter-observer variability in the interpretation of chest radiographs and increase participants' sensitivity, recall, and accuracy in pulmonary abnormality screening.

Detailed description

To investigate the effect of xrAI for radiologists that interpret chest radiographs as part of their daily responsibilities, the investigators have designed a randomized control trial. The pulmonary abnormalities detected by xrAI and included in the definition of abnormal are as follows: any linear scar or fibrosis, atelectasis, consolidation, abscess or cavity, nodule, pleural effusion, severe cases of emphysema and COPD (mild cases with hyperinflation but not significant emphysema are not flagged), and pneumothorax. To assess the causal effect of xrAI the investigators randomly assign 10 to 14 radiologists to either treatment (x-ray images processed by xrAI) or control (no xrAI processing) groups. Participants will only review images once. Each participant will perform 500 radiograph interpretations in total. Participants in the control group will be asked to interpret the same 500 images without xrAI's analysis. To increase the precision of the estimate and better investigate potential differences between clinical professionals, investigators block randomize the assignment of treatment or control group. To analyse the effect of xrAI, the investigators will estimate the average treatment effect (ATE) for each group by comparing the performance of the treatment and control groups using randomization-based inference (Green and Gerber, 2012).

Interventions

The pulmonary abnormalities detected by xrAI and included in the definition of abnormality are as follows: any linear scar or fibrosis, atelectasis, consolidation, abscess or cavity, nodule, pleural effusion, severe cases of emphysema and COPD (mild cases with hyperinflation but not significant emphysema are not flagged), pneumothorax. Participants in the treatment group will interpret 500 images presented alongside the results of xrAI's processing in a dark room and asked to categorize each image into one of the following categories: lungs are clear, at least one pulmonary abnormality is present, not sure. Participants in the control group will be asked to interpret the same 500 images as the treatment group but without xrAI's analysis.

Sponsors

1QB Information Technologies Inc.
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Subject)

Eligibility

Sex/Gender
ALL
Healthy volunteers
Yes

Inclusion criteria

* Radiologist currently practicing at a Pureform Radiology clinic in Calgary, Canada.

Exclusion criteria

* Radiologists not currently practicing at a Pureform Radiology clinic in Calgary, Canada. * Physicians currently practicing at a Pureform Radiology clinic in Calgary, Canada, but that are not radiologists by training.

Design outcomes

Primary

MeasureTime frameDescription
Number of abnormalities identified divided by number of total of images analyzed (accuracy)Time needed to analyze 500 images. Participants will be asked to completed the exercise within 2 weeks.Accuracy is defined as the ratio of the images where the physician's prediction matched the labels of the dataset. Accuracy= (TP+FP) / (TP+FP+TN+FN) TP (true positives) = cases interpreted as abnormal that are abnormal; FP (false positives) = cases wrongly interpreted to be abnormal; TN (true negatives) = cases correctly interpreted to be normal; FN (false negatives) = abnormal cases wrongly interpreted as normal.
Number of true abnormalities identified divided by the total of abnormalities identified (precision)Time needed to analyze 500 images. Participants will be asked to completed the exercise within 2 weeks.Precision is defined as the probability of a radiograph being abnormal if a physician makes the determination that it is abnormal. Precision= TP / (TP+FP) TP (true positives) = cases interpreted as abnormal that are abnormal; FP (false positives) = cases wrongly interpreted to be abnormal; TN (true negatives) = cases correctly interpreted to be normal; FN (false negatives) = abnormal cases wrongly interpreted as normal.
Number of true abnormalities identified divided by the sum of true abnormalities identified and abnormalities missed (recall)Time needed to analyze 500 images. Participants will be asked to completed the exercise within 2 weeks.Recall is defined as the probability of a physician catching an abnormality in an image if one exists (based on the labels of the dataset). Recall= TP / (TP+FN) TP (true positives) = cases interpreted as abnormal that are abnormal; FP (false positives) = cases wrongly interpreted to be abnormal; TN (true negatives) = cases correctly interpreted to be normal; FN (false negatives) = abnormal cases wrongly interpreted as normal.

Secondary

MeasureTime frameDescription
Mean of radiologist accuracy (as defined in outcome 1)Time needed to analyze 500 images. Participants will be asked to completed the exercise within 2 weeks.Investigators will calculate the mean of the accuracy of all participants in each group.
Mean of radiologist precision (as defined in outcome 2)Time needed to analyze 500 images. Participants will be asked to completed the exercise within 2 weeks.Investigators will calculate the mean of the precision of all participants in each group.
Mean of radiologist recall (as defined in outcome 3)Time needed to analyze 500 images. Participants will be asked to completed the exercise within 2 weeks.Investigators will calculate the mean of the recall of all participants in each group.

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026