No Chest CT for Diagnosis of COVID-19, Says AJR

Leesburg -According to an open-access clinical Perspective article in the American Journal of Roentgenology (AJR),the radiology literature on coronavirus disease(COVID-19) pneumonia has consisted of limited retrospective studies that do not substantiate the use of CT as a diagnostic test for COVID-19.

"This is not to say these studies are not valuable," maintained lead investigator Constantine A. Raptis of Washington University in Saint Louis. Raptis, Travis S. Henry of the University of California-San Francisco, and nine co-authors from six institutions across the United States noted of the most frequently cited studies on the subject, reporting the various CT features of COVID-19 pneumonia remains"an important first step"in helping radiologists identify patients who may have COVID-19 in the appropriate clinical environment.

"However," they continue,"test performance and management issues arise when inappropriate and potentially overreaching conclusions regarding the diagnostic performance of CT for COVID-19 pneumonia are based on low-quality studies with biased cohorts, confounding variables, and faulty design characteristics."

CT Sensitivity

Because misdiagnosing even a single patient (i.e., obtaining a false-negative finding) could result in large outbreaks among future contacts, understanding the potential effects of selection bias is important in determining sensitivity. As Raptis and colleagues explained, "if a study cohort contains patients who are more likely to have a true-positive finding and less likely to have a false-negative finding, the sensitivity will be overestimated."