Evidence mapPaperPMID 35080640Full record

ArticleDie Ophthalmologie2022

[Use of artificial intelligence in screening for diabetic retinopathy at a tertiary diabetes center].

Sebastian Paul, Allam Tayar, Ewa Morawiec-Kisiel, Beathe Bohl, Rico Großjohann, Elisabeth Hunfeld, Martin Busch, Johanna M Pfeil, Merlin Dähmcke, Tara Brauckmann and 9 more

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In one paragraph

Article in Die Ophthalmologie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.6field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 13 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 2 institutions in 1 country.

Sebastian PaulKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Allam TayarKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Ewa Morawiec-KisielKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Beathe BohlKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Rico GroßjohannKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Elisabeth HunfeldKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Martin BuschKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Johanna M PfeilKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Merlin DähmckeKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Tara BrauckmannKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Sonja EiltsKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Marie-Christine BründerKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Milena GrundelKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Bastian GrundelKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Frank TostKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland.
Jana KuhnKlinik für Diabetes und Stoffwechselerkrankungen Karlsburg, Klinikgruppe Dr. Guth GmbH & Co. KG, Karlsburg, Deutschland, Greifswalder Str. 11, 17495.
Jörg ReindelKlinik für Diabetes und Stoffwechselerkrankungen Karlsburg, Klinikgruppe Dr. Guth GmbH & Co. KG, Karlsburg, Deutschland, Greifswalder Str. 11, 17495.
Wolfgang KernerKlinik für Diabetes und Stoffwechselerkrankungen Karlsburg, Klinikgruppe Dr. Guth GmbH & Co. KG, Karlsburg, Deutschland, Greifswalder Str. 11, 17495.
Andreas StahlKlinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand Sauerbruch Str., 17475, Greifswald, Deutschland. andreas.stahl@med.uni-greifswald.de.
Universitätsmedizin Greifswald · DEInstitute for Diabetes Gerhardt Katsch · DE

Funding

Novartis Pharma Eyenovativ Förderpreis
6 · The paper itself

Abstract

backgroundIn 2018, IDx-DR was approved as a method to determine the degree of diabetic retinopathy (DR) using artificial intelligence (AI) by the FDA.

methodsWe integrated IDx-DR into the consultation at a diabetology focus clinic and report the agreement between IDx-DR and fundoscopy as well as IDx-DR and ophthalmological image assessment and the influence of different camera systems.

resultsAdequate image quality in miosis was achieved more frequently with the Topcon camera (n = 456; NW400, Topcon Medical Systems, Oakland, NJ, USA) compared with the Zeiss camera (n = 47; Zeiss VISUCAM 500, Carl Zeiss Meditec AG, Jena, Germany). Overall, IDx-DR analysis in miosis was possible in approximately 60% of the patients. All patients in whom IDx-DR analysis in miosis was not possible could be assessed by fundoscopy with dilated pupils. Within the group of images that could be evaluated, there was agreement between IDx-DR and ophthalmic fundoscopy in approximately 55%, overestimation of severity by IDx-DR in approximately 40% and underestimation in approximately 4%. The sensitivity (specificity) for detecting severe retinopathy requiring treatment was 95.7% (89.1%) for cases with fundus images that could be evaluated and 65.2% (66.7%) when all cases were considered (including those without images in miosis which could be evaluated). The kappa coefficient of 0.334 (p < 0.001) shows sufficient agreement between IDx-DR and physician's image analysis based on the fundus photograph, considering all patients with IDx-DR analysis that could be evaluated. The comparison between IDx-DR and the physician's funduscopy under the same conditions shows a low agreement with a kappa value of 0.168 (p < 0.001).

conclusionThe present study shows the possibilities and limitations of AI-assisted DR screening. A major limitation is that sufficient images cannot be obtained in miosis in approximately 40% of patients. When sufficient images were available the IDx-DR and ophthalmological diagnosis matched in more than 50% of cases. Underestimation of severity by IDx-DR occurred only rarely. For integration into an ophthalmologist's practice, this system seems suitable. Without access to an ophthalmologist the high rate of insufficient images in miosis represents an important limitation.

Indexed as

Diabetes MellitusDiabetic RetinopathyArtificial IntelligenceDiagnostic Techniques, OphthalmologicalFundus OculiHumansPhotographyArtificial intelligenceDiabetic retinopathyIDx-DRScreeningTelemedicine

Identifiers

PMID35080640
OpenAlexW4210582816

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.