Population-scale cross-sectional observational study for AI-powered TB screening on one million CXRs

Abstract Traditional tuberculosis (TB) screening involves radiologists manually reviewing chest X-rays (CXR), which is time-consuming, error-prone, and limited by workforce shortages. Our AI model, AIRIS-TB (AI Radiology In Screening TB), aims to address these challenges by automating the reporting...

Full description

Saved in:
Bibliographic Details
Main Authors: Prateek Munjal, Ahmed Al Mahrooqi, Ronnie Rajan, Andrew Jeremijenko, Iftikhar Ahmad, Muhammad Imran Akhtar, Marco A. F. Pimentel, Shadab Khan
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:npj Digital Medicine
Online Access:https://doi.org/10.1038/s41746-025-01832-7
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Traditional tuberculosis (TB) screening involves radiologists manually reviewing chest X-rays (CXR), which is time-consuming, error-prone, and limited by workforce shortages. Our AI model, AIRIS-TB (AI Radiology In Screening TB), aims to address these challenges by automating the reporting of all X-rays without any findings. AIRIS-TB was evaluated on over one million CXRs, achieving an AUC of 98.51% and overall false negative rate (FNR) of 1.57%, outperforming radiologists (1.85%) while maintaining a 0% TB-FNR. By selectively deferring only cases with findings to radiologists, the model has the potential to automate up to 80% of routine CXR reporting. Subgroup analysis revealed insignificant performance disparities across age, sex, HIV status, and region of origin, with sputum tests for suspected TB showing a strong correlation with model predictions. This large-scale validation demonstrates AIRIS-TB’s safety and efficiency in high-volume TB screening programs, reducing radiologist workload without compromising diagnostic accuracy.
ISSN:2398-6352