A large-scale clinical validation study using nCapp cloud plus terminal by frontline doctors for the rapid diagnosis of COVID-19 and COVID-19 pneumonia in China

Dawei Yang; Tao Xu; Xun Wang; Deng Chen; Ziqiang Zhang; Lichuan Zhang; Jie Liu; Kui Xiao; Li Bai; Yong Zhang; Lin Zhao; Lin Tong; Chaomin Wu; Yaoli Wang; Chunling Dong; Maosong Ye; Yu Xu; Zhenju Song; Hong Chen; Jing Li; Jiwei Wang; Fei Tan; Hai Yu; Jian Zhou; Chunhua Du; Hongqing Zhao; Yu Shang; Linian Huang; Jianping Zhao; Yang Jin; Charles A. Powell; Jinming Yu; Yuanlin Song; Chunxue Bai

Clinical eHealth (Dec 2022)

A large-scale clinical validation study using nCapp cloud plus terminal by frontline doctors for the rapid diagnosis of COVID-19 and COVID-19 pneumonia in China

Dawei Yang,
Tao Xu,
Xun Wang,
Deng Chen,
Ziqiang Zhang,
Lichuan Zhang,
Jie Liu,
Kui Xiao,
Li Bai,
Yong Zhang,
Lin Zhao,
Lin Tong,
Chaomin Wu,
Yaoli Wang,
Chunling Dong,
Maosong Ye,
Yu Xu,
Zhenju Song,
Hong Chen,
Jing Li,
Jiwei Wang,
Fei Tan,
Hai Yu,
Jian Zhou,
Chunhua Du,
Hongqing Zhao,
Yu Shang,
Linian Huang,
Jianping Zhao,
Yang Jin,
Charles A. Powell,
Jinming Yu,
Yuanlin Song,
Chunxue Bai

Affiliations

Dawei Yang: Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China; Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Shanghai Engineering Research Center of Internet of Things for Respiratory Medicine, Shanghai, China; Shanghai Key Laboratory of Lung Inflammation and Injury, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Respiratory Research Institution, Shanghai, China
Tao Xu: Department of Pulmonary and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China; Tongji Hospital, Tongji Medical College Huazhong University of Science & Technology, Wuhan, Hubei, China
Xun Wang: The Affiliated Wuxi No.2 People’s Hospital of Nanjing Medical University, Wuxi, Jiangsu, China; Wuhan Jiangxia First People's Hospital, Wuhan, Hubei, China
Deng Chen: School of Public Health, Fudan University, Shanghai, China
Ziqiang Zhang: Department of Respiratory Medicine, Tongji Hospital, Tongji University, Shanghai, China
Lichuan Zhang: Zhongshan Hospital Affiliated of Dalian University, Dalian, Liaoning, China
Jie Liu: Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China; Renmin Hospital of Wuhan University East Hospital, Wuhan, Hubei, China; Shanghai Key Laboratory of Lung Inflammation and Injury, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Respiratory Research Institution, Shanghai, China
Kui Xiao: Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
Li Bai: Department of Respiratory Critical Care Medicine, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Jinyintan Hospital Huhan City, Wuhan, Hubei, China
Yong Zhang: Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China; Renmin Hospital of Wuhan University East Hospital, Wuhan, Hubei, China; Shanghai Key Laboratory of Lung Inflammation and Injury, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Respiratory Research Institution, Shanghai, China
Lin Zhao: Department of Pulmonary and Critical Care Medicine, Rizhao People's Hospital, Rizhao, Shandong, China
Lin Tong: Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China; Shanghai Respiratory Research Institution, Shanghai, China
Chaomin Wu: Department of Pulmonary Medicine, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China; Jinyintan Hospital Huhan City, Wuhan, Hubei, China
Yaoli Wang: Wound Trauma Medical Center, State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing, China
Chunling Dong: The Second Hospital of Jilin University, Changchun, Jilin, China
Maosong Ye: Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China; Renmin Hospital of Wuhan University East Hospital, Wuhan, Hubei, China; Shanghai Key Laboratory of Lung Inflammation and Injury, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Respiratory Research Institution, Shanghai, China
Yu Xu: Department of Respiratory Critical Care Medicine, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Jinyintan Hospital Huhan City, Wuhan, Hubei, China; Huoshen Shan Hospital, Wuhan, Hubei, China
Zhenju Song: Department of Emergency Medicine, Zhongshan Hospital Fudan University, Shanghai, China; Shanghai Respiratory Research Institution, Shanghai, China
Hong Chen: Second Affiliated Hospital of Harbin Medical University, Harbin, Honglongjiang, China
Jing Li: Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China; Shanghai Engineering Research Center of Internet of Things for Respiratory Medicine, Shanghai, China
Jiwei Wang: School of Public Health, Fudan University, Shanghai, China
Fei Tan: Shanghai Duomu Vision Technology Co., Ltd, Shanghai, China
Hai Yu: Shanghai Duomu Vision Technology Co., Ltd, Shanghai, China
Jian Zhou: Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China; Shanghai Key Laboratory of Lung Inflammation and Injury, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Respiratory Research Institution, Shanghai, China
Chunhua Du: Department of Pulmonary and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
Hongqing Zhao: The Affiliated Wuxi No.2 People’s Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
Yu Shang: The First Hospital of Harbin, Harbin, Honglongjiang, China
Linian Huang: Department of Respiration and Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
Jianping Zhao: Tongji Hospital, Tongji Medical College Huazhong University of Science & Technology, Wuhan, Hubei, China
Yang Jin: Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Huhbei, China
Charles A. Powell: Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Jinming Yu: School of Public Health, Fudan University, Shanghai, China; Corresponding authors at: Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai Respiratory Research Institution, 180 Fenglin Rd, Shanghai 200032, China
Yuanlin Song: Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China; Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China; Shanghai Key Laboratory of Lung Inflammation and Injury, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Respiratory Research Institution, Shanghai, China; Corresponding authors at: Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai Respiratory Research Institution, 180 Fenglin Rd, Shanghai 200032, China
Chunxue Bai: Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China; Shanghai Key Laboratory of Lung Inflammation and Injury, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China; Shanghai Respiratory Research Institution, Shanghai, China; Corresponding authors at: Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai Respiratory Research Institution, 180 Fenglin Rd, Shanghai 200032, China

Journal volume & issue: Vol. 5
pp. 79 – 90

Abstract

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Background: The outbreak of coronavirus disease 2019 (COVID-19) has become a global pandemic acute infectious disease, especially with the features of possible asymptomatic carriers and high contagiousness. Currently, it is difficult to quickly identify asymptomatic cases or COVID-19 patients with pneumonia due to limited access to reverse transcription-polymerase chain reaction (RT-PCR) nucleic acid tests and CT scans. Goal: This study aimed to develop a scientific and rigorous clinical diagnostic tool for the rapid prediction of COVID-19 cases based on a COVID-19 clinical case database in China, and to assist doctors to efficiently and precisely diagnose asymptomatic COVID-19 patients and cases who had a false-negative RT-PCR test result. Methods: With online consent, and the approval of the ethics committee of Zhongshan Hospital Fudan University (NCT04275947, B2020-032R) to ensure that patient privacy is protected, clinical information has been uploaded in real-time through the New Coronavirus Intelligent Auto-diagnostic Assistant Application of cloud plus terminal (nCapp) by doctors from different cities (Wuhan, Shanghai, Harbin, Dalian, Wuxi, Qingdao, Rizhao, and Bengbu) during the COVID-19 outbreak in China. By quality control and data anonymization on the platform, a total of 3,249 cases from COVID-19 high-risk groups were collected. The effects of different diagnostic factors were ranked based on the results from a single factor analysis, with 0.05 as the significance level for factor inclusion and 0.1 as the significance level for factor exclusion. Independent variables were selected by the step-forward multivariate logistic regression analysis to obtain the probability model. Findings: We applied the statistical method of a multivariate regression model to the training dataset (1,624 cases) and developed a prediction model for COVID-19 with 9 clinical indicators that are accessible. The area under the receiver operating characteristic (ROC) curve (AUC) for the model was 0.88 (95% CI: 0.86, 0.89) in the training dataset and 0.84 (95% CI: 0.82, 0.86) in the validation dataset (1,625 cases). Discussion: With the assistance of nCapp, a mobile-based diagnostic tool developed from a large database that we collected from COVID-19 high-risk groups in China, frontline doctors can rapidly identify asymptomatic patients and avoid misdiagnoses of cases with false-negative RT-PCR results.

Published in Clinical eHealth

ISSN: 2588-9141 (Online)
Publisher: KeAi Communications Co., Ltd.
Country of publisher: China
LCC subjects: Medicine
Website: https://www.keaipublishing.com/en/journals/clinical-ehealth/

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