Use of computer-aided detection software for tuberculosis screening: WHO policy statement

This WHO policy statement provides guidance on the use of computer-aided detection (CAD) software for interpreting digital chest X-rays in tuberculosis (TB) screening among individuals aged 15 years and older. The document responds to the growing availability of CAD technologies and the need for evidence-based guidance to support countries, implementers and funders in selecting software products that meet WHO performance standards. It summarizes the independent evaluation conducted by the WHO Technical Advisory Group on Tuberculosis Diagnostics and Laboratory Strengthening using curated image libraries for community-based and facility-based screening, with microbiological reference standards and expert human readers as comparators.

The report presents the methods, performance criteria and diagnostic accuracy results for eight CAD software products submitted for assessment in 2025. Based on measures including partial area under the curve and specificity at fixed sensitivity thresholds, six products were found to meet WHO performance standards for pulmonary TB screening. The document also discusses implementation considerations, operational challenges, regulatory aspects and future perspectives for CAD technologies, emphasizing the importance of calibration, integration into health information systems and continued evaluation of software performance across different populations and settings.