India's goal to eliminate TB by 2025, set by Prime Minister Modi, appears to be lagging due to slow progress within the Health Ministry.
HTAIn Report Delay: A Health Technology Assessment of India (HTAIn) report on two indigenous AI-assisted chest X-ray solutions (qXR and Genki) for TB screening, completed in February 2024, was only published on the HTAIn website in December 2024.
HTA Process and CTD's Role: While HTA assessment isn't mandatory, the Central TB Division (CTD) typically waits for HTA reports and MTAB approval before implementing new TB tools or treatments.
Inconsistent Implementation: Despite HTA and MTAB approval, qXR and Genki haven't been programmatically implemented by the CTD. However, a similar tool, DeepCXR, was recommended without HTA assessment.
DeepCXR Implementation Issues: The CTD recommended DeepCXR to states, but only when states specifically requested AI solutions.
This was communicated informally, not officially. DeepCXR is provided free of cost.
DeepCXR Data Concerns: While DeepCXR is claimed to have high accuracy, there are limited publicly available data or published studies on its performance, sensitivity, and specificity in real-world settings.
qXR and Genki Evidence: In contrast, qXR and Genki have published studies demonstrating their performance.
qXR, with high sensitivity and specificity, is WHO-referenced and used in numerous countries. Genki is also implemented across multiple sites in India.
Cost-Effectiveness of qXR and Genki: The HTA assessment found both qXR and Genki to be cost-effective, with per-screening costs of ₹30 and ₹22, respectively.
They also meet WHO's accuracy standards.
Importance of Chest X-rays for TB Screening: Chest X-rays are crucial for detecting TB, as evidenced by national prevalence surveys.
AI-assisted interpretation of these X-rays is fast, accurate, and cost-effective, making it suitable for resource-limited settings.
Call to Action: The information suggests a need for more rapid and consistent implementation of proven AI-based TB screening tools to meet India's TB elimination goal.
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