Evidence map›Paper›PMID 39169209›Full record

ArticleCommunications medicine2024

Predicting 1, 2 and 3 year emergent referable diabetic retinopathy and maculopathy using deep learning.

Paul Nderitu, Joan M Nunez do Rio, Laura Webster, Samantha Mann, M Jorge Cardoso, Marc Modat, David Hopkins, Christos Bergeles, Timothy L Jackson

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Article in Communications medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

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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

5 citing papers in PubMed.

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4 · The record

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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

9 authors.

Paul NderituSection of Ophthalmology, Faculty of Life Sciences and Medicine, King's College London, London, UK. p.nderitu@doctors.org.uk.ORCID http://orcid.org/0000-0002-8571-0751
Joan M Nunez do RioDepartment of Ophthalmology, King's Ophthalmology Research Unit (KORU), King's College Hospital, London, UK.
Laura WebsterDepartment of Ophthalmology, South East London Diabetic Eye Screening Service, St Thomas' Hospital, London, UK.
Samantha MannDepartment of Ophthalmology, South East London Diabetic Eye Screening Service, St Thomas' Hospital, London, UK.ORCID http://orcid.org/0000-0003-0407-4501
M Jorge CardosoSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.ORCID http://orcid.org/0000-0003-1284-2558
Marc ModatSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
David HopkinsInstitute of Diabetes, Endocrinology and Obesity, King's Health Partners, London, UK.
Christos BergelesSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.ORCID http://orcid.org/0000-0002-9152-3194
Timothy L JacksonSection of Ophthalmology, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Funding

Diabetes UK 20/0006144Wellcome Trust
6 · The paper itself

Abstract

backgroundPredicting diabetic retinopathy (DR) progression could enable individualised screening with prompt referral for high-risk individuals for sight-saving treatment, whilst reducing screening burden for low-risk individuals. We developed and validated deep learning systems (DLS) that predict 1, 2 and 3 year emergent referable DR and maculopathy using risk factor characteristics (tabular DLS), colour fundal photographs (image DLS) or both (multimodal DLS).

methodsFrom 162,339 development-set eyes from south-east London (UK) diabetic eye screening programme (DESP), 110,837 had eligible longitudinal data, with the remaining 51,502 used for pretraining. Internal and external (Birmingham DESP, UK) test datasets included 27,996, and 6928 eyes respectively.

resultsInternal multimodal DLS emergent referable DR, maculopathy or either area-under-the receiver operating characteristic (AUROC) were 0.95 (95% CI: 0.92-0.98), 0.84 (0.82-0.86), 0.85 (0.83-0.87) for 1 year, 0.92 (0.87-0.96), 0.84 (0.82-0.87), 0.85 (0.82-0.87) for 2 years, and 0.85 (0.80-0.90), 0.79 (0.76-0.82), 0.79 (0.76-0.82) for 3 years. External multimodal DLS emergent referable DR, maculopathy or either AUROC were 0.93 (0.88-0.97), 0.85 (0.80-0.89), 0.85 (0.76-0.85) for 1 year, 0.93 (0.89-0.97), 0.79 (0.74-0.84), 0.80 (0.76-0.85) for 2 years, and 0.91 (0.84-0.98), 0.79 (0.74-0.83), 0.79 (0.74-0.84) for 3 years.

conclusionsMultimodal and image DLS performance is significantly better than tabular DLS at all intervals. DLS accurately predict 1, 2 and 3 year emergent referable DR and referable maculopathy using colour fundal photographs, with additional risk factor characteristics conferring improvements in prognostic performance. Proposed DLS are a step towards individualised risk-based screening, whereby AI-assistance allows high-risk individuals to be closely monitored while reducing screening burden for low-risk individuals.

Identifiers

PMID39169209
PMCPMC11339445

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Registered trials

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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.