This multicenter, prospective study aims to evaluate the real-world clinical utility of chest X-ray (CXR) for large-scale thoracic disease screening. Adult participants presenting for health examinations will undergo digital CXR screening, and any suspected abnormalities will be confirmed via a gold standard reference, such as a chest CT scan or clinical follow-up. The primary outcome measure is the detection rate (screening yield) of confirmed thoracic conditions. Secondary measures will assess diagnostic accuracy (sensitivity and specificity), false-positive rates, and multi-center reading consistency. By providing prospective, large-cohort evidence, this research seeks to validate the cost-effectiveness and feasibility of CXR in identifying early-stage lung, pleural, and cardiac abnormalities, ultimately guiding public health strategies and optimizing early medical intervention.
Study Type
OBSERVATIONAL
Enrollment
300,000
Dazhou Central Hospital
Dazhou, Sichuan, China
RECRUITINGOverall Detection Rate of Thoracic Diseases
Defined as the proportion of subjects with positive X-ray findings that are subsequently confirmed by a gold standard reference (e.g., CT scan, pathology, or comprehensive clinical follow-up) out of the total screened population.
Time frame: Through study completion, an average of 1 year.
Screening Yield
Defined as the number of newly identified, clinically significant thoracic disease cases detected per 1,000 screening examinations.
Time frame: Through study completion, an average of 1 year.
Diagnostic Performance Metrics
Evaluating the diagnostic accuracy of chest X-rays using CT as the gold standard. Metrics include: Sensitivity and Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV), Miss Rate (False Negative Rate), with a specific focus on early-stage lung nodules and occult pneumonia.
Time frame: Through study completion, an average of 1 year.
Multi-center Consistency and Inter-reader Reliability
Assessed using agreement coefficients (e.g., Cohen's Kappa or Intraclass Correlation Coefficient \[ICC\]) among radiologists with varying levels of experience across different participating centers when interpreting the radiographs.
Time frame: Through study completion, an average of 1 year.
Disease-Specific Detection Rates
Stratified detection rates for specific thoracic abnormalities, including but not limited to pulmonary nodules (lung nodules), pneumonia, pneumothorax, cardiomegaly, and pleural effusion.
Time frame: Through study completion, an average of 1 year.
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