JMIR research protocols · 2025
Clinical and Economic Evaluation of a Real-Time Chest X-Ray Computer-Aided Detection System for Misplaced Endotracheal and Nasogastric Tubes and Pneumothorax in Emergency and Critical Care Settings: Protocol for a Cluster Randomized Controlled Trial.
СтатьяПротокол клинического исследованияПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Tsai Chu-Lin, Chu Teresa Cheng-Chieh, Wang Chih-Hung, Chang Wei-Tien, Tsai Min-Shan, Ku Shih-Chi, Lin Yen-Hung, Tai Hao-Chih, Kuo Shuenn-Wen, Wang Kuo-Chuan, Chao Anne, Tang Sung-Chun, Liu Wei-Lun, Tsai Ming-Han, Wang Ting-Ann, Chuang Shu-Lin, Lee Yi-Chia, Kuo Lu-Cheng, Chen Chiuan-Jung, Kao Jia-Horng, Wang Weichung, Huang Chien-Hua
Аннотация
BACKGROUND: Advancements in artificial intelligence (AI) have driven substantial breakthroughs in computer-aided detection (CAD) for chest x-ray (CXR) imaging. The National Taiwan University Hospital research team previously developed an AI-based emergency CXR system (Capstone project), which led to the creation of a CXR module. This CXR module has an established model supported by extensive research and is ready for application in clinical trials without requiring additional model training. This study will use 3 submodules of the system: detection of misplaced endotracheal tubes, detection of misplaced nasogastric tubes, and identification of pneumothorax.
OBJECTIVE: This study aims to apply a real-time CXR CAD system in emergency and critical care settings to evaluate its clinical and economic benefits without requiring additional CXR examinations or altering standard care and procedures. The study will evaluate the impact of CAD system on mortality reduction, postintubation complications, hospital stay duration, workload, and interpretation time, as wells as conduct a cost-effectiveness comparison with standard care.
METHODS: This study adopts a pilot trial and cluster randomized controlled trial design, with random assignment conducted at the ward level. In the intervention group, units are granted access to AI diagnostic results, while the control group continues standard care practices. Consent will be obtained from attending physicians, residents, and advanced practice nurses in each participating ward. Once consent is secured, these health care providers in the intervention group will be authorized to use the CAD system. Intervention units will have access to AI-generated interpretations, whereas control units will maintain routine medical procedures without access to the AI diagnostic outputs.
RESULTS: The study was funded in September 2024. Data collection is expected to last from January 2026 to December 2027.
CONCLUSIONS: This study anticipates that the real-time CXR CAD system will automate the identification and detection of misplaced endotracheal and nasogastric tubes on CXRs, as well as assist clinicians in diagnosing pneumothorax. By reducing the workload of physicians, the system is expected to shorten the time required to detect tube misplacement and pneumothorax, decrease patient mortality and hospital stays, and ultimately lower health care costs.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/72928.
OBJECTIVE: This study aims to apply a real-time CXR CAD system in emergency and critical care settings to evaluate its clinical and economic benefits without requiring additional CXR examinations or altering standard care and procedures. The study will evaluate the impact of CAD system on mortality reduction, postintubation complications, hospital stay duration, workload, and interpretation time, as wells as conduct a cost-effectiveness comparison with standard care.
METHODS: This study adopts a pilot trial and cluster randomized controlled trial design, with random assignment conducted at the ward level. In the intervention group, units are granted access to AI diagnostic results, while the control group continues standard care practices. Consent will be obtained from attending physicians, residents, and advanced practice nurses in each participating ward. Once consent is secured, these health care providers in the intervention group will be authorized to use the CAD system. Intervention units will have access to AI-generated interpretations, whereas control units will maintain routine medical procedures without access to the AI diagnostic outputs.
RESULTS: The study was funded in September 2024. Data collection is expected to last from January 2026 to December 2027.
CONCLUSIONS: This study anticipates that the real-time CXR CAD system will automate the identification and detection of misplaced endotracheal and nasogastric tubes on CXRs, as well as assist clinicians in diagnosing pneumothorax. By reducing the workload of physicians, the system is expected to shorten the time required to detect tube misplacement and pneumothorax, decrease patient mortality and hospital stays, and ultimately lower health care costs.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/72928.