AI Article Synopsis
- * Researchers conducted a retrospective analysis of 241 patients and found that type 1 diabetes, smoking, and older age were significant factors linked to nondiagnostic results.
- * A new predictive workflow was created to prioritize pharmacologic dilation for patients most likely to benefit, potentially increasing the effectiveness of diabetic retinal examinations compared to standard reflexive dilation.
Article Abstract
Objective: In the pivotal clinical trial that led to Food and Drug Administration De Novo "approval" of the first fully autonomous artificial intelligence (AI) diabetic retinal disease diagnostic system, a reflexive dilation protocol was used. Using real-world deployment data before implementation of reflexive dilation, we identified factors associated with nondiagnostic results. These factors allow a novel workflow, where patients most likely to benefit from pharmacologic dilation are dilated to maximize efficiency and patient satisfaction.
Methods: Retrospective review of patients who were assessed with autonomous AI at Johns Hopkins Medicine (8/2020 to 5/2021). We constructed a multivariable logistic regression model for nondiagnostic results to compare characteristics of patients with and without diagnostic results, using adjusted odds ratio (aOR). < .05 was considered statistically significant.
Results: Of 241 patients (59% female; median age = 59), 123 (51%) had nondiagnostic results. In multivariable analysis, type 1 diabetes (T1D, aOR = 5.82, 95% confidence interval [CI]: 1.45-23.40, = .01), smoking (aOR = 2.86, 95% CI: 1.36-5.99, = .005), and age (every 10-year increase, aOR = 2.12, 95% CI: 1.62-2.77, < .001) were associated with nondiagnostic results. Following feature elimination, a predictive model was created using T1D, smoking, age, race, sex, and hypertension as inputs. The model showed an area under the receiver-operator characteristics curve of 0.76 in five-fold cross-validation.
Conclusions: We used factors associated with nondiagnostic results to design a novel, predictive dilation workflow, where patients most likely to benefit from pharmacologic dilation are dilated . This new workflow has the potential to be more efficient than reflexive dilation, thus maximizing the number of at-risk patients receiving their diabetic retinal examinations.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10973867 | PMC |
| http://dx.doi.org/10.1177/19322968231201654 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Epidemiology of epiretinal membranes using spectral-domain optical coherence tomography in an Iranian elderly population.
Optom Vis Sci
January 2025
Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Significance: Epidemiological information about the epiretinal membrane is important for better clinical management and understanding of the nature and burden of this disease. There are some gaps in our understanding of the epidemiology of epiretinal membranes, particularly in Africa and the Middle East.
Purpose: This study aimed to determine the prevalence and risk factors of epiretinal membrane using spectral-domain optical coherence tomography (OCT) in an Iranian elderly population.
Nighttime systolic blood pressure a major factor of retinal vascular caliber changes in patients with newly diagnosed type 2 diabetes mellitus.
Am J Hypertens
January 2025
3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Greece.
Background: Changes in retinal vessel caliber are crucial for detecting early retinopathy, a significant cause of blindness in individuals with Diabetes Mellitus type 2 (T2DM). This study aims to evaluate the changes in retinal vessel caliber and identify factors associated with these changes in recently diagnosed T2DM patients.
Methods: The study included newly diagnosed T2DM patients (within 6 months of diagnosis) who were free of antidiabetic treatment (except metformin) and matched individuals based on age and blood pressure (BP).
Estimating Visual Acuity With Spectacle Correction From Fundus Photos Using Artificial Intelligence.
JAMA Netw Open
January 2025
Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Importance: Determining spectacle-corrected visual acuity (VA) is essential when managing many ophthalmic diseases. If artificial intelligence (AI) evaluations of macular images estimated this VA from a fundus image, AI might provide spectacle-corrected VA without technician costs, reduce visit time, or facilitate home monitoring of VA from fundus images obtained outside of the clinic.
Objective: To estimate spectacle-corrected VA measured on a standard eye chart among patients with diabetic macular edema (DME) in clinical practice settings using previously validated AI algorithms evaluating best-corrected VA from fundus photographs in eyes with DME.
Transforming Non-Digital, Clinical Workflows to Detect and Track Vision-Threatening Diabetic Retinopathy via a Digital Platform Integrating Artificial Intelligence: Implementation Research.
Ophthalmol Ther
January 2025
International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi, Thailand.
Introduction: Screening diabetic retinopathy (DR) for timely management can reduce global blindness. Many existing DR screening programs worldwide are non-digital, standalone, and deployed with grading retinal photographs by trained personnel. To integrate the screening programs, with or without artificial intelligence (AI), into hospital information systems to improve their effectiveness, the non-digital workflow must be transformed into digital.
View Article and Find Full Text PDFRisk for Ocular Hypertension With Intravitreal Dexamethasone Implants in Black and White Patients With Diabetic Macular Edema.
J Vitreoretin Dis
January 2025
Georgia Retina, Atlanta, GA, USA.
To compare the effects of intravitreal (IVT) 0.7 mg dexamethasone implants on the intraocular pressure (IOP) in Black patients and White patients with diabetic macular edema (DME). A retrospective cohort study was performed of Black patients and White patients with DME who received dexamethasone implants with 12 or more months of follow-up.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!