Use caution in overinterpreting preliminary or flawed data, say three U.S. radiologists from University of California, San Francisco; San Francisco Veterans Affairs Medical Center; and Washington University School of Medicine. They express their views on the use of chest CT to detect COVID-19 in the lungs in an April 8 Ideas and Opinions column from Annals of Internal Medicine:
Amidst the coronavirus disease 2019 (COVID-19) pandemic, there is great pressure on physicians to provide clarity and answers. Good science, however, takes time and careful consideration to prove the value of advancements in diagnosis and treatment. We would like to share what we believe is a classic arc of events for a new imaging indication in the radiology literature: A rush to publish positive results leads to their overinterpretation and, consequently, the dissemination of premature conclusions with broad implications. Although this has occurred before with imaging, our recent experience is unique in that the implications are far-reaching and potentially of immediate importance.
The shortage of rapid and highly sensitive reverse transcriptase polymerase chain reaction (RT-PCR) tests for the diagnosis of COVID-19 has led many in the health care community to consider a screening or diagnostic role for imaging. Publications from China during the outbreak there suggest a central role for computed tomography (CT). Fang and colleagues reported CT findings of pneumonia in 50 of 51 patients with RT-PCR–proven COVID-19 (1). Ai and colleagues then reported CT findings of pneumonia in 580 of 601 patients with RT-PCR–proven COVID-19 (2). Together, these publications ostensibly present a compelling story for CT, with sensitivities for the diagnosis of COVID-19 reported as 98% and 97%, respectively. Ai and colleagues concluded that chest CT may be used as a primary tool for detecting COVID-19 in epidemic areas.
Read more from Annals of Internal Medicine.
Featured image: CT scan of a patient with COVID-19.
