Evidence map›Paper›PMID 35902186›Full record

ArticleBMJ open2022

Automated multidimensional deep learning platform for referable diabetic retinopathy detection: a multicentre, retrospective study.

Guihua Zhang, Jian-Wei Lin, Ji Wang, Jie Ji, Ling-Ping Cen, Weiqi Chen, Peiwen Xie, Yi Zheng, Yongqun Xiong, Hanfu Wu and 4 more

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 14% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Article
  5. Observational
  6. Automated Lung and Colon Cancer Classification Using Histopathological Images.Biomedical engineering and computational biology · 2024
    Article
  7. On the Analyses of Medical Images Using Traditional Machine Learning Techniques and Convolutional Neural Networks.Archives of computational methods in engineering : state of the art reviews · 2023
    Article
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

14 authors at 2 institutions in 2 countries.

Guihua Zhang *Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Jian-Wei Lin *Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Ji Wang *Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.ORCID 0000-0001-6997-3837
Jie Ji *The big data center, Shantou University Medical College, Shantou, China.
Ling-Ping CenJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Weiqi ChenJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.ORCID 0000-0003-2852-8192
Peiwen XieJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Yi ZhengJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Yongqun XiongJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Hanfu WuJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Dongjie LiJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Tsz Kin NgJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.ORCID 0000-0001-7863-7229
Chi Pui PangJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Mingzhi ZhangJoint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China zmz@jsiec.org.ORCID 0000-0001-9032-7274
Chinese University of Hong Kong · HKShantou University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo develop and validate a real-world screening, guideline-based deep learning (DL) system for referable diabetic retinopathy (DR) detection.

designThis is a multicentre platform development study based on retrospective, cross-sectional data sets. Images were labelled by two-level certificated graders as the ground truth. According to the UK DR screening guideline, a DL model based on colour retinal images with five-dimensional classifiers, namely image quality, retinopathy, maculopathy gradability, maculopathy and photocoagulation, was developed. Referable decisions were generated by integrating the output of all classifiers and reported at the image, eye and patient level. The performance of the DL was compared with DR experts.

settingDR screening programmes from three hospitals and the Lifeline Express Diabetic Retinopathy Screening Program in China.

participants83 465 images of 39 836 eyes from 21 716 patients were annotated, of which 53 211 images were used as the development set and 30 254 images were used as the external validation set, split based on centre and period. MAIN OUTCOMES: Accuracy, F1 score, sensitivity, specificity, area under the receiver operating characteristic curve (AUROC), area under the precision-recall curve (AUPRC), Cohen's unweighted κ and Gwet's AC1 were calculated to evaluate the performance of the DL algorithm.

resultsIn the external validation set, the five classifiers achieved an accuracy of 0.915-0.980, F1 score of 0.682-0.966, sensitivity of 0.917-0.978, specificity of 0.907-0.981, AUROC of 0.9639-0.9944 and AUPRC of 0.7504-0.9949. Referable DR at three levels was detected with an accuracy of 0.918-0.967, F1 score of 0.822-0.918, sensitivity of 0.970-0.971, specificity of 0.905-0.967, AUROC of 0.9848-0.9931 and AUPRC of 0.9527-0.9760. With reference to the ground truth, the DL system showed comparable performance (Cohen's κ: 0.86-0.93; Gwet's AC1: 0.89-0.94) with three DR experts (Cohen's κ: 0.89-0.96; Gwet's AC1: 0.91-0.97) in detecting referable lesions.

conclusionsThe automatic DL system for detection of referable DR based on the UK guideline could achieve high accuracy in multidimensional classifications. It is suitable for large-scale, real-world DR screening.

Indexed as

Deep LearningDiabetes MellitusDiabetic RetinopathyMacular DegenerationCross-Sectional StudiesHumansRetrospective Studiesdiabetic retinopathymedical retinavetreoretinal

Identifiers

PMID35902186
PMCPMC9341185
OpenAlexW4288462095

What OpenQuestion holds

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LicenceCC BY-NC
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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 OpenQuestion graph.