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We developed a machine learning (ML)-based CT texture analysis software for simple triage based on the RSNA Expert Consensus Statement system. The purpose of this study was to conduct a multi-center and multi-reader study to determine the capability of ML-based computer-aided simple triage (CAST)\u00a0software based on RSNA expert consensus statements for diagnosis of COVID-19 pneumonia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>For this multi-center study, 174 cases who had undergone CT and polymerase chain reaction (PCR) tests for COVID-19 were retrospectively included. Their CT data were then assessed by CAST and consensus from three board-certified chest radiologists, after which all cases were classified as either positive or negative. Diagnostic performance was then compared by McNemar\u2019s test. To determine radiological finding evaluation capability of CAST, three other board-certified chest radiologists assessed CAST results for radiological findings into five criteria. Finally, accuracies of all radiological evaluations were compared by McNemar\u2019s test.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A comparison of diagnosis for COVID-19 pneumonia based on RT-PCR results for cases with COVID-19 pneumonia findings on CT showed no significant difference of diagnostic performance between ML-based CAST software and consensus evaluation (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Comparison of agreement on accuracy for all radiological finding evaluations showed that emphysema evaluation accuracy for investigator A (AC\u2009=\u200991.7%) was significantly lower than that for investigators B (100%, <jats:italic>p<\/jats:italic>\u2009=\u20090.0009) and C (100%, <jats:italic>p<\/jats:italic>\u2009=\u20090.0009).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This multi-center study shows COVID-19 pneumonia triage by CAST can be considered at least as valid as that by chest expert radiologists and may be capable for playing as useful a complementary role for management of suspected COVID-19 pneumonia patients as well as the RT-PCR test in routine clinical practice.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11604-023-01495-y","type":"journal-article","created":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T06:02:26Z","timestamp":1697781746000},"page":"276-290","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Machine learning-based computer-aided simple triage (CAST) for COVID-19 pneumonia as compared with triage by board-certified chest radiologists"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4431-1084","authenticated-orcid":false,"given":"Yoshiharu","family":"Ohno","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takatoshi","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Endo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisanobu","family":"Koyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Moriya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumito","family":"Okada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanori","family":"Higashino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruka","family":"Sato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriko","family":"Oyama-Manabe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takafumi","family":"Haraguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazumasa","family":"Arakita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kota","family":"Aoyagi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiro","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeo","family":"Kaminaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Taniguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Sugihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,10,20]]},"reference":[{"key":"1495_CR1","unstructured":"WHO Coronavirus (COVID-19) Dashboard. 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Drs. Ohno and Haraguchi received research grants from Canon Medical Systems Corporation, which also supported this work technically. Dr. Ohno received research grants from Grants-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology (JSTS.KAKEN; No. 18K07675 and JSTS.KAKEN; No. 20K08037) and the Smoking-Research Foundation. Messer. Arakita, Aoyagi, Ikeda, Kaminaga, Taniguchi and Sugihara were employees of Canon Medical Systems Corporation. Moreover, all authors and our institution and department chair, Prof. Yoshiharu Ohno, who is the corresponding author, agree to publication.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Training and validation cases were retrospectively obtained with institutional review board approval from Fujita Health University Hospital and Kansai Medical University Medical Center. Both institutions received research grants from Canon Medical Systems. The test study was a retrospective study approved by the certified review board of Fujita Health University Hospital, which served as the coordinating center, and subsequently approved by the directors of Jichi Medical University Saitama Medical Center and St. Marianna University School of Medicine prior to site initiation. This study was compliant with the Health Insurance Portability and Accountability Act, written informed consent was waived, and it was technically and financially supported by Canon Medical Systems Corporation. Moreover, this study was financially supported by\u00a0Grants-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology (JSTS.KAKEN; No. 18K07675 and JSTS.KAKEN; No. 20K08037) and the Smoking-Research Foundation. Six of the authors, Kazumasa Arakita, Kota Aoyagi, Yoshihiro Ikeda, Shigeo Kaminaga, Akira Taniguchi, Naoki Sugihara, are employees of Canon Medical Systems Corporation (Otawara, Tochigi, Japan) who did not have control over any of the data used in this study. Two employees of Micron, Inc., (Tokyo, Japan), which is an international clinical research organization (CRO), handled all data, and performed all statistical analyses independently from the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}