ArticleFrontiers in endocrinology2025
Universal nomogram for predicting referable diabetic retinopathy: a validated model for community and ophthalmic outpatient populations using easily accessible indicators.
Article in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Early proteomic and metabolomic signatures in diabetes associated with progression to diabetic retinopathy over 1-2 years.Frontiers in endocrinology · 2026Article
- Construction of a dynamic prediction model for diabetic retinopathy risk in adults with adult-onset type 1 diabetes: a real-world longitudinal cohort study.Frontiers in clinical diabetes and healthcare · 2026Article
- Federated multimodal AI for precision-equitable diabetes care.Frontiers in digital health · 2025Review
- A panoramic perspective: application prospects and outlook of multimodal artificial intelligence in the management of diabetic retinopathy.Frontiers in public health · 2025Review
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8 authors.
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Abstract
Purpose: This study aimed to develop and validate a universal nomogram for predicting referable diabetic retinopathy (RDR) in type 2 diabetes mellitus (T2DM) patients, using easily accessible clinical indicators for both community and ophthalmic outpatient populations. Methods: A cross-sectional study was conducted with 1,830 T2DM patients from 14 communities in Xi'an, Shaanxi, China. Participants completed questionnaires, underwent physical exams, and ophthalmic assessments. Univariate analysis and least absolute shrinkage and selection operator (LASSO) regression identified key predictors for RDR. A nomogram was developed using multivariable logistic regression. Model performance was evaluated through area under the curve (AUC), accuracy, precision, recall, F1 score, Youden index, calibration curves, and decision curve analysis (DCA). The dataset was split into training (80%) and test (20%) sets, with external validation using 123 T2DM outpatients from Shaanxi Eye Hospital. Results: Seven key predictors were identified: serum creatinine, urea nitrogen, urine glucose, HbA1c, urinary microalbumin, diabetes duration, and systolic blood pressure. The nomogram exhibited moderate predictive accuracy, with AUCs of 0.730 (95% CI: 0.691-0.759), 0.767 (95% CI: 0.704-0.831), and 0.723 (95% CI: 0.610-0.835) for the training, test, and external validation sets, respectively. DCA showed that using the model is beneficial for threshold probabilities between 8% and 72%, supporting its broad clinical utility. Conclusion: This nomogram, based on readily available clinical indicators, provides a reliable and scalable tool for predicting RDR risk in both community and ophthalmic settings. It offers a practical solution for early detection and personalized management of RDR, with broad applicability and clinical potential.
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