Deep learning model to predict the need for mechanical ventilation using chest X-ray images in hospitalised patients with COVID-19. Issue 2 (2nd March 2021)

• Record Type: Journal Article
• Authors: Kulkarni, Anoop R; Athavale, Ambarish M; Sahni, Ashima; Sukhal, Shashvat; Saini, Abhimanyu; Itteera, Mathew; Zhukovsky, Sara; Vernik, Jane; Abraham, Mohan; Joshi, Amit; Amarah, Amatur; Ruiz, Juan; Hart, Peter D; Kulkarni, Hemant
• Is Part Of: BMJ innovations. Volume 7:Issue 2(2021)
• Page Start: 261
• Page End: 270
• Publication Date: 2021-03-02
• Subjects: critical care -- COVID-19 -- radiology; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjinnov-2020-000593
• Languages: English
• ISSNs: 2055-8074

Abstract

Abstract : Objectives: There exists a wide gap in the availability of mechanical ventilator devices and their acute need in the context of the COVID-19 pandemic. An initial triaging method that accurately identifies the need for mechanical ventilation in hospitalised patients with COVID-19 is needed. We aimed to investigate if a potentially deteriorating clinical course in hospitalised patients with COVID-19 can be detected using all X-ray images taken during hospitalisation. Methods: We exploited the well-established DenseNet121 deep learning architecture for this purpose on 663 X-ray images acquired from 528 hospitalised patients with COVID-19. Two Pulmonary and Critical Care experts blindly and independently evaluated the same X-ray images for the purpose of validation. Results: We found that our deep learning model predicted the need for mechanical ventilation with a high accuracy, sensitivity and specificity (90.06%, 86.34% and 84.38%, respectively). This prediction was done approximately 3 days ahead of the actual intubation event. Our model also outperformed two Pulmonary and Critical Care experts who evaluated the same X-ray images and provided an incremental accuracy of 7.24%–13.25%. Conclusions: Our deep learning model accurately predicted the need for mechanical ventilation early during hospitalisation of patients with COVID-19. Until effective preventive or treatment measures become widely available for patients with COVID-19, prognostic stratification as provided by our model is likely to be highly valuable.