Performance of an artificial intelligence automated system for diabetic eye screening in a large English population.

AIMS: A diabetic eye screening programme has huge value in reducing avoidable sight loss by identifying diabetic retinopathy at a stage when it can be treated. Artificial intelligence automated systems can be used for diabetic eye screening but are not employed in the national English Diabetic Eye Screening Programme. The aim was to report the performance of a commercially available deep-learning artificial intelligence software in a large English population. METHODS: 9817 anonymised image sets from 10,000 consecutive diabetic eye screening episodes were presented to an artificial intelligence software. The sensitivity and specificity of the artificial intelligence system for detecting diabetic retinopathy were determined using the diabetic eye screening programme manual grade according to national protocols as the reference standard. RESULTS: For no diabetic retinopathy versus any diabetic retinopathy, the sensitivity of the artificial intelligence grading system was 69.7% and specificity 92.2%. The performance of the artificial intelligence system was superior for no or mild diabetic retinopathy versus significant or referrable diabetic retinopathy with a sensitivity of 95.4% and specificity of 92.0%. No cases were identified in which the artificial intelligence grade had missed significant diabetic retinopathy. CONCLUSION: The performance of a commercially available deep-learning artificial intelligence system for identifying diabetic retinopathy in an English national Diabetic Eye Screening Programme is presented. Using the pre-defined settings artificial intelligence performance was highest when identifying diabetic retinopathy which requires an action by the screening programme.

Dyslexia debated, then and now: a historical perspective on the dyslexia debate.

The 'dyslexia debate' is resilient. In the media, a key component of the debate is the notion that dyslexia does not exist, popularised by a series of vociferous commentators. For them, dyslexia is an invention of overly-concerned parents, supported by a clique of private educational psychologists willing to offer a diagnosis - for a fee - even where no condition exists. In academic circles, especially psychology, dyslexia critiques are also present. In these, the principal argument is that the term 'dyslexia' is unhelpful - more an emotive word designed to attract funding, than a clearly defined scientific condition. Such arguments stand against other research in psychology, and discussion has become contentious. Largely missing from both sides of the debate, however, is a historical perspective. In this article, the origins of the dyslexia debate are traced, showing how queries about the term's efficacy have marked dyslexia's history since it was first identified in the 1870s. Through this tracing, this account seeks to move discussion beyond the existing either/or binary of dyslexia's existence.

Literacy, Advocacy and Agency: The Campaign for Political Recognition of Dyslexia in Britain (1962-1997).

This article charts the campaign for political recognition of dyslexia in Britain, focusing on the period from 1962 when concerted interest in the topic began. Through the Word Blind Centre for Dyslexic Children (1963-72), and the organisations that followed, it shows how dyslexia gradually came to be institutionalised, often in the face of government intransigence. The article shows how this process is best conceived as a complex interplay of groups, including advocates, researchers, civil servants and politicians of varying political stripes. Necessarily, the campaign was mediated through broader political, economic and social changes, including the increasing requirement for literacy in the productive worker, but it is not reducible to these factors. In this way, the article reflects on the conceptualisation of power and agency in accounts of the history of dyslexia to date and its broader relevance to the history of learning difficulties and disabilities.

Acute lymphoblastic leukemia presenting with urticarial plaques and hypereosinophilia in a child.

Our report describes a previously healthy 10-year-old female who was seen for urticarial plaques and mild loss of appetite. An initial laboratory workup revealed an elevated leukocyte count of 30,000/microL and a peripheral eosinophil count of 22,500/microL. A skin biopsy showed a marked hypersensitivity tissue response with abundant eosinophils. Further investigation of her peripheral eosinophilia uncovered Giardia lamblia in a stool sample. Despite treatment with the anti-parasitic agent furazolidone, the patient's urticarial plaques, leukocyte count, and peripheral eosinophil count remained unchanged. A bone marrow biopsy confirmed a diagnosis of acute lymphoblastic leukemia (ALL). ALL with hypereosinophilia (ALL/Eo) represents a rare and distinct subset of ALL, with more than 30 cases documented in the literature. Our discussion summarizes the clinical aspects of this disease and reviews the reported dermatological manifestations of ALL/Eo.