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10.1007/s10140-020-01821-1

http://scihub22266oqcxt.onion/10.1007/s10140-020-01821-1
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32691211!7369539!32691211
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suck abstract from ncbi


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pmid32691211      Emerg+Radiol 2020 ; 27 (6): 641-651
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  • Chest CT for triage during COVID-19 on the emergency department: myth or truth? #MMPMID32691211
  • Hermans JJR; Groen J; Zwets E; Boxma-De Klerk BM; Van Werkhoven JM; Ong DSY; Hanselaar WEJJ; Waals-Prinzen L; Brown V
  • Emerg Radiol 2020[Dec]; 27 (6): 641-651 PMID32691211show ga
  • PURPOSE: We aimed to investigate the diagnostic performance of chest CT compared with first RT-PCR results in adult patients suspected of COVID-19 infection in an ED setting. We also constructed a predictive machine learning model based on chest CT and additional data to improve the diagnostic accuracy of chest CT. METHODS: This study's cohort consisted of 319 patients who underwent chest CT and RT-PCR testing at the ED. Patient characteristics, demographics, symptoms, vital signs, laboratory tests, and chest CT results (CO-RADS) were collected. With first RT-PCR as reference standard, the diagnostic performance of chest CT using the CO-RADS score was assessed. Additionally, a predictive machine learning model was constructed using logistic regression. RESULTS: Chest CT, with first RT-PCR as a reference, had a sensitivity, specificity, PPV, and NPV of 90.2%, 88.2%, 84.5%, and 92.7%, respectively. The prediction model with CO-RADS, ferritin, leucocyte count, CK, days of complaints, and diarrhea as predictors had a sensitivity, specificity, PPV, and NPV of 89.3%, 93.4%, 90.8%, and 92.3%, respectively. CONCLUSION: Chest CT, using the CO-RADS scoring system, is a sensitive and specific method that can aid in the diagnosis of COVID-19, especially if RT-PCR tests are scarce during an outbreak. Combining a predictive machine learning model could further improve the accuracy of diagnostic chest CT for COVID-19. Further candidate predictors should be analyzed to improve our model. However, RT-PCR should remain the primary standard of testing as up to 9% of RT-PCR positive patients are not diagnosed by chest CT or our machine learning model.
  • |*Emergency Service, Hospital[MESH]
  • |*Triage[MESH]
  • |Adolescent[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Betacoronavirus[MESH]
  • |COVID-19[MESH]
  • |COVID-19 Testing[MESH]
  • |COVID-19 Vaccines[MESH]
  • |Clinical Laboratory Techniques[MESH]
  • |Coronavirus Infections/diagnosis/*diagnostic imaging/epidemiology[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Machine Learning[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Netherlands/epidemiology[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*diagnostic imaging/epidemiology[MESH]
  • |Prospective Studies[MESH]
  • |Radiography, Thoracic/*methods[MESH]
  • |SARS-CoV-2[MESH]
  • |Sensitivity and Specificity[MESH]


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