Early user experience and lessons learned using ultra-portable digital X-ray with computer-aided detection (DXR-CAD) products: A qualitative study from the perspective of healthcare providers.

<h4>Background</h4>Recent technological and radiological advances have renewed interest in using X-rays to screen and triage people with tuberculosis (TB). The miniaturization of digital X-ray (DXR), combined with automatic interpretation using computer-aided detection (CAD) software can...

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Main Authors: Zhi Zhen Qin, Rachael Barrett, Maria Del Mar Castro, Sarah Zaidi, Andrew J Codlin, Jacob Creswell, Claudia M Denkinger
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0277843
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author Zhi Zhen Qin
Rachael Barrett
Maria Del Mar Castro
Sarah Zaidi
Andrew J Codlin
Jacob Creswell
Claudia M Denkinger
author_facet Zhi Zhen Qin
Rachael Barrett
Maria Del Mar Castro
Sarah Zaidi
Andrew J Codlin
Jacob Creswell
Claudia M Denkinger
author_sort Zhi Zhen Qin
collection DOAJ
description <h4>Background</h4>Recent technological and radiological advances have renewed interest in using X-rays to screen and triage people with tuberculosis (TB). The miniaturization of digital X-ray (DXR), combined with automatic interpretation using computer-aided detection (CAD) software can extend the reach of DXR screening interventions for TB. This qualitative study assessed early implementers' experiences and lessons learned when using ultra-portable (UP) DXR systems integrated with CAD software to screen and triage TB.<h4>Methods</h4>Semi-structured interviews were conducted with project staff and healthcare workers at six pilot sites. Transcripts were coded and analyzed using a framework approach. The themes that emerged were subsequently organized and presented using the Consolidated Framework for Implementation Research (CFIR).<h4>Results</h4>There were 26 interviewees with varying roles: supervisory, clinicians, radiographers, and radiologists. Participants recognized the portability as the main advantage, but criticize that it involves several compromises on throughput, internet dependence, manoeuvrability, and stability, as well as suitability for patients with larger body sizes. Furthermore, compared to using hardware and software from the same supplier and without digital health information systems, complexity increases with interoperability between hardware and software, and between different electronic health information systems. Currently, there is a limited capacity to implement these technologies, especially due to the need for threshold selection, and lack of guidance on radiation protection suitable for UP DXR machines. Finally, the respondents stressed the importance of having protected means of sharing patient medical data, as well as comprehensive support and warranty plans.<h4>Conclusion</h4>Study findings suggest that UP DXR with CAD was overall well received to decentralize radiological assessment for TB, however, the improved portability involved programmatic compromises. The main barriers to uptake included insufficient capacity and lack of guidance on radiation protection suitable for UP DXR.
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spelling doaj.art-55a10c8998c24950b25d971f02dc99332023-03-30T05:31:26ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01182e027784310.1371/journal.pone.0277843Early user experience and lessons learned using ultra-portable digital X-ray with computer-aided detection (DXR-CAD) products: A qualitative study from the perspective of healthcare providers.Zhi Zhen QinRachael BarrettMaria Del Mar CastroSarah ZaidiAndrew J CodlinJacob CreswellClaudia M Denkinger<h4>Background</h4>Recent technological and radiological advances have renewed interest in using X-rays to screen and triage people with tuberculosis (TB). The miniaturization of digital X-ray (DXR), combined with automatic interpretation using computer-aided detection (CAD) software can extend the reach of DXR screening interventions for TB. This qualitative study assessed early implementers' experiences and lessons learned when using ultra-portable (UP) DXR systems integrated with CAD software to screen and triage TB.<h4>Methods</h4>Semi-structured interviews were conducted with project staff and healthcare workers at six pilot sites. Transcripts were coded and analyzed using a framework approach. The themes that emerged were subsequently organized and presented using the Consolidated Framework for Implementation Research (CFIR).<h4>Results</h4>There were 26 interviewees with varying roles: supervisory, clinicians, radiographers, and radiologists. Participants recognized the portability as the main advantage, but criticize that it involves several compromises on throughput, internet dependence, manoeuvrability, and stability, as well as suitability for patients with larger body sizes. Furthermore, compared to using hardware and software from the same supplier and without digital health information systems, complexity increases with interoperability between hardware and software, and between different electronic health information systems. Currently, there is a limited capacity to implement these technologies, especially due to the need for threshold selection, and lack of guidance on radiation protection suitable for UP DXR machines. Finally, the respondents stressed the importance of having protected means of sharing patient medical data, as well as comprehensive support and warranty plans.<h4>Conclusion</h4>Study findings suggest that UP DXR with CAD was overall well received to decentralize radiological assessment for TB, however, the improved portability involved programmatic compromises. The main barriers to uptake included insufficient capacity and lack of guidance on radiation protection suitable for UP DXR.https://doi.org/10.1371/journal.pone.0277843
spellingShingle Zhi Zhen Qin
Rachael Barrett
Maria Del Mar Castro
Sarah Zaidi
Andrew J Codlin
Jacob Creswell
Claudia M Denkinger
Early user experience and lessons learned using ultra-portable digital X-ray with computer-aided detection (DXR-CAD) products: A qualitative study from the perspective of healthcare providers.
PLoS ONE
title Early user experience and lessons learned using ultra-portable digital X-ray with computer-aided detection (DXR-CAD) products: A qualitative study from the perspective of healthcare providers.
title_full Early user experience and lessons learned using ultra-portable digital X-ray with computer-aided detection (DXR-CAD) products: A qualitative study from the perspective of healthcare providers.
title_fullStr Early user experience and lessons learned using ultra-portable digital X-ray with computer-aided detection (DXR-CAD) products: A qualitative study from the perspective of healthcare providers.
title_full_unstemmed Early user experience and lessons learned using ultra-portable digital X-ray with computer-aided detection (DXR-CAD) products: A qualitative study from the perspective of healthcare providers.
title_short Early user experience and lessons learned using ultra-portable digital X-ray with computer-aided detection (DXR-CAD) products: A qualitative study from the perspective of healthcare providers.
title_sort early user experience and lessons learned using ultra portable digital x ray with computer aided detection dxr cad products a qualitative study from the perspective of healthcare providers
url https://doi.org/10.1371/journal.pone.0277843
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