Venediktos V Kapetanakis1, Alicja R Rudnicka2, Gerald Liew3, Christopher G Owen2, Aaron Lee4, Vern Louw4, Louis Bolter5, John Anderson5, Catherine Egan4, Sebastian Salas-Vega6, Caroline Rudisill6, Paul Taylor7, Adnan Tufail4. 1. Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, United Kingdom vkapetan@sgul.ac.uk. 2. Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, United Kingdom. 3. Centre for Vision Research, University of Sydney, NSW 2006, Australia. 4. Moorfields BRC, Moorfields Eye Hospital, London, EC1V 2PD, United Kingdom. 5. Homerton University Hospital, Homerton Row, E9 6SR. 6. Department of Social Policy, LSE Health, London School of Economics and Political Science, London, WC2A 2AE, United Kingdom. 7. CHIME, Institute of Health Informatics, University College London, London, NW1 2HE, United Kingdom.
Abstract
OBJECTIVES: Diabetic retinopathy screening in England involves labour intensive manual grading of digital retinal images. We present the plan for an observational retrospective study of whether automated systems could replace one or more steps of human grading. METHODS: Patients aged 12 or older who attended the Diabetes Eye Screening programme, Homerton University Hospital (London) between 1 June 2012 and 4 November 2013 had macular and disc-centred retinal images taken. All screening episodes were manually graded and will additionally be graded by three automated systems. Each system will process all screening episodes, and screening performance (sensitivity, false positive rate, likelihood ratios) and diagnostic accuracy (95% confidence intervals of screening performance measures) will be quantified. A sub-set of gradings will be validated by an approved Reading Centre. Additional analyses will explore the effect of altering thresholds for disease detection within each automated system on screening performance. RESULTS: 2,782/20,258 diabetes patients were referred to ophthalmologists for further examination. Prevalence of maculopathy (M1), pre-proliferative retinopathy (R2), and proliferative retinopathy (R3) were 7.9%, 3.1% and 1.2%, respectively; 4749 (23%) patients were diagnosed with background retinopathy (R1); 1.5% were considered ungradable by human graders. CONCLUSIONS: Retinopathy prevalence was similar to other English diabetic screening programmes, so findings should be generalizable. The study population size will allow the detection of differences in screening performance between the human and automated grading systems as small as 2%. The project will compare performance and economic costs of manual versus automated systems.
OBJECTIVES:Diabetic retinopathy screening in England involves labour intensive manual grading of digital retinal images. We present the plan for an observational retrospective study of whether automated systems could replace one or more steps of human grading. METHODS:Patients aged 12 or older who attended the Diabetes Eye Screening programme, Homerton University Hospital (London) between 1 June 2012 and 4 November 2013 had macular and disc-centred retinal images taken. All screening episodes were manually graded and will additionally be graded by three automated systems. Each system will process all screening episodes, and screening performance (sensitivity, false positive rate, likelihood ratios) and diagnostic accuracy (95% confidence intervals of screening performance measures) will be quantified. A sub-set of gradings will be validated by an approved Reading Centre. Additional analyses will explore the effect of altering thresholds for disease detection within each automated system on screening performance. RESULTS: 2,782/20,258 diabetespatients were referred to ophthalmologists for further examination. Prevalence of maculopathy (M1), pre-proliferative retinopathy (R2), and proliferative retinopathy (R3) were 7.9%, 3.1% and 1.2%, respectively; 4749 (23%) patients were diagnosed with background retinopathy (R1); 1.5% were considered ungradable by human graders. CONCLUSIONS:Retinopathy prevalence was similar to other English diabetic screening programmes, so findings should be generalizable. The study population size will allow the detection of differences in screening performance between the human and automated grading systems as small as 2%. The project will compare performance and economic costs of manual versus automated systems.
Authors: Igor Kozak; John F Payne; Patrik Schatz; Eman Al-Kahtani; Moritz Winkler Journal: Graefes Arch Clin Exp Ophthalmol Date: 2017-04-26 Impact factor: 3.117
Authors: Yuchen Xie; Dinesh V Gunasekeran; Konstantinos Balaskas; Pearse A Keane; Dawn A Sim; Lucas M Bachmann; Carl Macrae; Daniel S W Ting Journal: Transl Vis Sci Technol Date: 2020-04-13 Impact factor: 3.283