AIDCOV: An Interpretable Artificial Intelligence Model for Detection of COVID-19 from Chest Radiography Images

As the Coronavirus Disease 2019 (COVID-19) pandemic continues to grow globally, testing to detect COVID-19 and isolating individuals who test positive remains to be the primary strategy for preventing community spread of the disease. The current gold standard method of testing for COVID-19 is the reverse transcription polymerase chain reaction (RT-PCR) test. The RT-PCR test, however, has an imperfect sensitivity (around 70%), is time-consuming and labor-intensive, and is in short supply, particularly in resource-limited countries. Therefore, automatic and accurate detection of COVID-19 using medical imaging modalities such as chest X-ray and Computed Tomography, which are more widely available and accessible, can be beneficial. We develop a novel hierarchical attention neural network model to classify chest radiography images as belonging to a person with either COVID-19, other infections, or no pneumonia (i.e., normal). We refer to this model as Artificial Intelligence for Detection of COVID-19 (AIDCOV). The hierarchical structure in AIDCOV captures the dependency of features and improves model performance while the attention mechanism makes the model interpretable and transparent. Using a publicly available dataset of 5801 chest images, we demonstrate that our model achieves a mean cross-validation accuracy of 97.8%. AIDCOV has a sensitivity of 99.3%, a specificity of 99.98%, and a positive predictive value of 99.6% in detecting COVID-19 from chest radiography images. AIDCOV can be used in conjunction with or instead of RT-PCR testing (where RT-PCR testing is unavailable) to detect and isolate individuals with COVID-19 and prevent onward transmission to the general population and healthcare workers.