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Real-world evaluation of smartphone-based artificial intelligence to screen for diabetic retinopathy in Dominica: a clinical validation study.
Kemp, Oliver; Bascaran, Covadonga; Cartwright, Edyta; McQuillan, Lauren; Matthew, Nanda; Shillingford-Ricketts, Hazel; Zondervan, Marcia; Foster, Allen; Burton, Matthew.
Afiliación
  • Kemp O; London School of Hygiene and Tropical Medicine, London, UK.
  • Bascaran C; London School of Hygiene and Tropical Medicine, London, UK covadonga.bascaran@lshtm.ac.uk.
  • Cartwright E; University Hospitals Sussex NHS Foundation Trust, Worthing, UK.
  • McQuillan L; University Hospitals Sussex NHS Foundation Trust, Worthing, UK.
  • Matthew N; Dominica China Friendship Hospital, Roseau, Dominica.
  • Shillingford-Ricketts H; Dominica China Friendship Hospital, Roseau, Dominica.
  • Zondervan M; London School of Hygiene and Tropical Medicine, London, UK.
  • Foster A; London School of Hygiene and Tropical Medicine, London, UK.
  • Burton M; London School of Hygiene and Tropical Medicine, London, UK.
BMJ Open Ophthalmol ; 8(1)2023 12 21.
Article en En | MEDLINE | ID: mdl-38135351
ABSTRACT

OBJECTIVE:

Several artificial intelligence (AI) systems for diabetic retinopathy screening have been validated but there is limited evidence on their performance in real-world settings. This study aimed to assess the performance of an AI software deployed within the diabetic retinopathy screening programme in Dominica. METHODS AND

ANALYSIS:

We conducted a prospective, cross-sectional clinical validation study. Patients with diabetes aged 18 years and above attending the diabetic retinopathy screening in primary care facilities in Dominica from 5 June to 3 July 2021 were enrolled.Grading was done at the point of care by the field grader, followed by counselling and referral to the eye clinic. Images were then graded by an AI system. Sensitivity, specificity with 95% CIs and area under the curve (AUC) were calculated for comparing the AI to field grader as gold standard.

RESULTS:

A total of 587 participants were screened. The AI had a sensitivity and specificity for detecting referable diabetic retinopathy of 77.5% and 91.5% compared with the grader, for all participants, including ungradable images. The AUC was 0.8455. Excluding 52 participants deemed ungradable by the grader, the AI had a sensitivity and specificity of 81.4% and 91.5%, with an AUC of 0.9648.

CONCLUSION:

This study provides evidence that AI has the potential to be deployed to assist a diabetic screening programme in a middle-income real-world setting and perform with reasonable accuracy compared with a specialist grader.
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Diabetes Mellitus / Retinopatía Diabética País/Región como asunto: Caribe / Caribe ingles / Dominica Idioma: En Revista: BMJ Open Ophthalmol Año: 2023 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Diabetes Mellitus / Retinopatía Diabética País/Región como asunto: Caribe / Caribe ingles / Dominica Idioma: En Revista: BMJ Open Ophthalmol Año: 2023 Tipo del documento: Article