Two-component organizational model for clinical and radiological screening for pulmonary tuberculosis in a sparsely populated territory of the Sakha Republic (Yakutia)

Abstract

Background. The challenges of organizing tuberculosis detection in sparsely populated areas are primarily associated with poor transportation access and a shortage of medical personnel. Under these conditions, the implementation of modern information technologies in clinical and radiological screening for the disease becomes highly relevant. Aim . To optimize methods for the detection and diagnosis of pulmonary tuberculosis using information technologies in the sparsely populated territory of the Republic of Sakha (Yakutia). Methods . A pilot study was conducted in seven medical organizations of the Republic of Sakha (Yakutia) to test a two-component organizational model for clinical and radiological tuberculosis screening utilizing information technologies: a central medical image archive and telemedicine for remote diagnosis, as well as artificial intelligence for double reading of fluorograms. Effectiveness was assessed by monthly monitoring of population coverage with fluorographic examinations, measuring the time spent on double reading of fluorograms, and assessing the time to tuberculosis diagnosis. Results. The pilot implementation of the two-component organizational model for clinical and radiological tuberculosis screening, employing information technologies and artificial intelligence in medical organizations, led to increased fluorographic examination coverage of the general population and individuals at risk for tuberculosis. This implementation also reduced the time required for double reading of fluorograms and shortened tuberculosis diagnostic timelines, both in the general medical network and at the specialized tuberculosis service level. Considering the specific characteristics of tuberculosis detection organization across different socio-territorial zones of the Far North, a model for clinical and radiological screening of pulmonary tuberculosis was developed. This model comprises two organizational variants tailored for use in the Arctic and industrial zones. The model consists of three stages (radiological, clinical, and specialized) implemented at the level of the central district hospital departments. Conclusion . The proposed model for tuberculosis screening using information technologies is recommended for implementation in sparsely populated districts of the Far North.