Artificial Intelligence-Based Evaluation of Chest X-Rays in Ventilator-Associated Pneumonia

March 31, 2026 updated by: Arif Timuroğlu, MD, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

Artificial Intelligence-Based Evaluation of Chest X-Rays in the Diagnosis of Ventilator-Associated Pneumonia in the Intensive Care Unit: A Retrospective Comparative Study

Ventilator-associated pneumonia (VAP) is a common and serious infection in critically ill patients receiving mechanical ventilation in intensive care units (ICUs). One of the key diagnostic criteria for VAP is the presence of a new or progressive infiltrate on chest X-ray; however, interpretation of bedside chest radiographs is often challenging and subject to inter-observer variability.

This retrospective observational study aims to evaluate the role of artificial intelligence (AI) in the assessment of chest X-rays in patients with VAP. Chest radiographs obtained before and at the time of VAP diagnosis will be analyzed using a deep learning-based AI tool (Chester the AI Radiology Assistant), and changes in "infiltration" and "pneumonia" probability scores will be assessed.

AI-based findings will be compared with clinical decisions and independent radiologist evaluations regarding the presence of new infiltrates. The study aims to determine the level of agreement between these approaches and to explore whether AI-based analysis can support a more objective and standardized interpretation of chest radiographs in the diagnosis of VAP.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
119

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Ankara
      • Yenimahalle, Ankara, Turkey (Türkiye), 06370
        • Dr. Abdurrahman Yurtaslan Ankara Oncology Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population consists of adult patients admitted to a tertiary care anesthesia intensive care unit who required invasive mechanical ventilation and received a clinical diagnosis of ventilator-associated pneumonia (VAP). Patients were identified retrospectively through hospital electronic medical records and infection control committee databases. This cohort represents a critically ill ICU population with high disease severity and diverse comorbid conditions.

Description

Inclusion Criteria:

  • Adult patients (≥18 years)
  • Admission to the anesthesia intensive care unit
  • Requirement of invasive mechanical ventilation for at least 48 hours
  • Clinical diagnosis of ventilator-associated pneumonia (VAP) based on institutional criteria
  • Availability of at least one chest X-ray prior to VAP diagnosis and one chest X-ray at the time of diagnosis
  • Availability of digital chest radiographs in the PACS system suitable for analysis

Exclusion Criteria:

  • Age <18 years
  • Absence of accessible digital chest radiographs
  • Chest radiographs with severe technical limitations preventing evaluation
  • Chest radiographs that could not be processed by the AI system (no score generated)
  • Presence of extensive pre-existing infiltrative lung disease preventing reliable assessment of new infiltrates
  • Missing key clinical data (e.g., VAP diagnosis date, mechanical ventilation duration)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
VAP Patients
This cohort includes adult patients admitted to the anesthesia intensive care unit who were mechanically ventilated for at least 48 hours and received a clinical diagnosis of ventilator-associated pneumonia (VAP). For each patient, chest radiographs obtained prior to and at the time of VAP diagnosis were analyzed. Images were evaluated by three approaches: clinical assessment, independent radiologist interpretation, and artificial intelligence-based analysis using the Chester AI system. The study is observational, and no intervention was applied.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Chester AI-derived Infiltration and Pneumonia Probability Scores Between Pre-diagnosis and VAP Diagnosis Chest X-rays
Time Frame: From pre-diagnosis chest X-ray to the time of VAP diagnosis (typically within 1-5 days)
The primary outcome is the change in probability scores for "infiltration" and "pneumonia" generated by the Chester AI Radiology Assistant between chest X-rays obtained prior to VAP diagnosis and those obtained at the time of diagnosis. These scores range from 0 to 1 and represent the likelihood of the presence of each finding.
From pre-diagnosis chest X-ray to the time of VAP diagnosis (typically within 1-5 days)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 1, 2026

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
March 20, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 25, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
March 26, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 31, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
April 3, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 3, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 31, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2026-02/23

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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