Статья

Diagnostic Accuracy of Computed Tomography for Identifying Hospitalization in Patients with Suspected COVID-19

S. Morozov, R. Reshetnikov, V. Gombolevskiy, N. Ledikhova, I. Blokhin, K. Vg, V. Oamav,
2020

The controversy of computed tomography (CT) use in COVID-19 screening is associated with ambiguous characteristics of chest CT as a diagnostic test. The reported values of CT sensitivity and specificity calculated using RT-PCR as a reference standard vary widely. The objective of this study was to reevaluate the diagnostic and prognostic value of CT using an alternative approach. This study included 973 symptomatic COVID-19 patients aged 42 $\pm$ 17 years, 56% females. We reviewed the disease dynamics between the initial and follow-up CT studies using a "CT0-4" grading system. Sensitivity and specificity were calculated as conditional probabilities that a patient's condition would improve or deteriorate relative to the initial CT study results. For the calculation of negative (NPV) and positive (PPV) predictive values, we estimated the COVID-19 prevalence in Moscow. We used several ARIMA and EST models with different parameters to fit the data on total cases of COVID-19 from March 6, 2020, to July 20, 2020, and forecast the incidence. The "CT0-4" grading scale demonstrated low sensitivity (28%) but high specificity (95%). The best statistical model for describing the pandemic in Moscow was ETS with multiplicative trend, error, and season type. According to our calculations, with the predicted prevalence of 2.1%, the values of NPV and PPV would be 98% and 10%, correspondingly. We associate the low sensitivity and PPV values with the small sample size of the patients with severe symptoms and non-optimal methodological setup for measuring these specific characteristics. The "CT0-4" grading scale was highly specific and predictive for identifying admissions to hospitals of COVID-19 patients. Despite the ambiguous accuracy, chest CT proved to be an effective practical tool for patient management during the pandemic, provided that the necessary infrastructure and human resources are available.

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Версии

  • 1. Version of Record от 2020-07-29

Метаданные

Об авторах
  • S. Morozov
  • R. Reshetnikov
    Moscow State University
  • V. Gombolevskiy
  • N. Ledikhova
  • I. Blokhin
  • K. Vg
  • V. Oamav
Предметная рубрика
  • COVID-19
Название журнала
  • arXiv: Quantitative Methods
Источник
  • lens