Journal article
Automated analysis of retinal images for detection of referable diabetic retinopathy
JAMA ophthalmology, Vol.131(3), pp.351-357
03/2013
DOI: 10.1001/jamaophthalmol.2013.1743
PMID: 23494039
Abstract
The diagnostic accuracy of computer detection programs has been reported to be comparable to that of specialists and expert readers, but no computer detection programs have been validated in an independent cohort using an internationally recognized diabetic retinopathy (DR) standard. To determine the sensitivity and specificity of the Iowa Detection Program (IDP) to detect referable diabetic retinopathy (RDR). In primary care DR clinics in France, from January 1, 2005, through December 31, 2010, patients were photographed consecutively, and retinal color images were graded for retinopathy severity according to the International Clinical Diabetic Retinopathy scale and macular edema by 3 masked independent retinal specialists and regraded with adjudication until consensus. The IDP analyzed the same images at a predetermined and fixed set point. We defined RDR as more than mild nonproliferative retinopathy and/or macular edema. A total of 874 people with diabetes at risk for DR. Sensitivity and specificity of the IDP to detect RDR, area under the receiver operating characteristic curve, sensitivity and specificity of the retinal specialists' readings, and mean interobserver difference (κ). The RDR prevalence was 21.7% (95% CI, 19.0%-24.5%). The IDP sensitivity was 96.8% (95% CI, 94.4%-99.3%) and specificity was 59.4% (95% CI, 55.7%-63.0%), corresponding to 6 of 874 false-negative results (none met treatment criteria). The area under the receiver operating characteristic curve was 0.937 (95% CI, 0.916-0.959). Before adjudication and consensus, the sensitivity/specificity of the retinal specialists were 0.80/0.98, 0.71/1.00, and 0.91/0.95, and the mean intergrader κ was 0.822. The IDP has high sensitivity and specificity to detect RDR. Computer analysis of retinal photographs for DR and automated detection of RDR can be implemented safely into the DR screening pipeline, potentially improving access to screening and health care productivity and reducing visual loss through early treatment.
Details
- Title: Subtitle
- Automated analysis of retinal images for detection of referable diabetic retinopathy
- Creators
- Michael D Abràmoff - Department of Ophthalmology and Visual Sciences, 11205 PFP, University of Iowa Hospital and Clinics, 200 Hawkins Dr, Iowa City, IA 52242, USA. michael-abramoff@uiowa.eduJames C FolkDennis P HanJonathan D WalkerDavid F WilliamsStephen R RussellPascale MassinBeatrice CochenerPhilippe GainLi TangMathieu LamardDaniela C MogaGwénolé QuellecMeindert Niemeijer
- Resource Type
- Journal article
- Publication Details
- JAMA ophthalmology, Vol.131(3), pp.351-357
- Publisher
- United States
- DOI
- 10.1001/jamaophthalmol.2013.1743
- PMID
- 23494039
- ISSN
- 2168-6165
- eISSN
- 2168-6173
- Grant note
- This study was supported by grants NEI EY017066, R01 EY018853, and R01 EY019112 from the Research to Prevent Blindness, New York, New York (University of Iowa and Medical College of Wisconsin) and grant UL1RR024979 from the National Center for Research Resources, National Institutes of Health. Dr Russell is the Dina J. Schrage Professor for Macular Degeneration Research. Dr Folk is the Judith Gardner and Donald H. Beisner, MD, Professor of Vitreoretinal Diseases and Surgery. Dr Han is the Jack A. and Elaine D. Klieger Professor of Ophthalmology. Role of the Sponsor: No other sponsor had any role in the study design, conduct, collection, management, analysis, or interpretation of the data or preparation, review, or approval of the manuscript
- Language
- English
- Date published
- 03/2013
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Electrical and Computer Engineering; Ophthalmology and Visual Sciences
- Record Identifier
- 9983805904702771
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