NasogastriX

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About the App

NasogastriX is a series of educational modules and mini games aimed to support students in improving their practical knowledge of nasogastric tube assessment on chest x-ray.

Nasogastric tube (NGT) misplacement is a high-risk clinical error that can lead to serious complications, including lung injury, pneumothorax, and even death. Accurate interpretation of NGT positioning on chest X-ray (CXR) is an essential skill for medical students, clinicians, and health care professionals. However, confidence and competence in this area can be limited due to variability in training and limited exposure. NasogastriX was developed to address this gap by providing interactive electronic teaching modules that support the accurate recognition of both normal and abnormal NGT positioning on CXR and detection of complications. By combining visual learning with gamified elements, NasogastriX a flexible and effective tool for self-directed learning.

Key Modules

Overview of the App

Click the image to find out more about the different elements of the app and the individual games.

1

Main Page

Check for updates of the leaderboard, andnavigate to individual games

2

Character

Meet and select your own character!

3

Normal or Abnormal

This game aims to test students’ ability to accurately detect normal and abnormal positions of nasogastric tubes. Students review each chest x-ray to determine whether the position of the nasogastric tube is normal or abnormal.

An artificial intelligence machine learning algorithm trained and validated for classification of normal and abnormal nasogastric tube position, which will process each image and determine whether the tube position is normal or abnormal. Students’ answers will be marked against the answer provided by the machine learning algorithm.

4

Journey of Radiology NGTs

Navigate your character through the path by answering questions correctly. Each question will be a multiple choice question, and your character will advance one step with each correct answer. If your answer to a question is incorrect, your character will remain in the same position and a 3 second time penalty will be given before you are able to re-attempt the question to move on.

5

Tube Builder

Choose the correct position of different segments of a nasogastric tube to build its path through the esophagus to the stomach.

Artificial Intelligence

AI Integration + Grad-CAM

We incorporated artificial intelligence(AI) elements into the games by embedding a deep learning model trained and validated for NGT detection and classification. The tube is segmented and then classified into abnormal, indeterminate (incomplete), or normal.

Grad-CAM heat maps

Grad-CAMs (Gradient-weighted ClassActivation Maps) are a tool used to show which parts of an image a model focuses on when making decisions. Specifically, they analyze the model’s final convolutional layer, which contains the most detailed information about the image. By looking at how much the model’s predictions change in response to different regions, Grad-CAMs highlight the areas that are most important for identifying a certain type of tube or line. These important regions appear as bright red spots on a heat map, making it easy to see what the model considers key features. After each attempt, these heat maps are created to serve as visual references to help students interpret the positioning on the CXR.

FAQ

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Privacy

Privacy Policy

We value your privacy. NasogastriX collects only essential data to improve app functionality, and does not share your personal data without consent.

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