Evidence map›Paper›PMID 36619716›Full record

ArticleOphthalmology science2023

DDLSNet: A Novel Deep Learning-Based System for Grading Funduscopic Images for Glaucomatous Damage.

Haroon Adam Rasheed, Tyler Davis, Esteban Morales, Zhe Fei, Lourdes Grassi, Agustina De Gainza, Kouros Nouri-Mahdavi, Joseph Caprioli

Open access · goldAbstract read
In one paragraph

Article in Ophthalmology science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.2field-weighted citation impact, top 12% 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

4 citing papers in PubMed, 11 citations in OpenAlex.

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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

8 authors at 2 institutions in 1 country.

Haroon Adam RasheedUniversity of California Los Angeles David Geffen School of Medicine, Los Angeles, California.
Tyler DavisDepartment of Computer Science, University of California Los Angeles, Los Angeles, California.
Esteban MoralesGlaucoma Division, Jules Stein Eye Institute, Los Angeles, California.
Zhe FeiUniversity of California Los Angeles Jonathan and Karin Fielding School of Public Health, Los Angeles, California.
Lourdes GrassiGlaucoma Division, Jules Stein Eye Institute, Los Angeles, California.
Agustina De GainzaGlaucoma Division, Jules Stein Eye Institute, Los Angeles, California.
Kouros Nouri-MahdaviGlaucoma Division, Jules Stein Eye Institute, Los Angeles, California.
Joseph CaprioliGlaucoma Division, Jules Stein Eye Institute, Los Angeles, California.
University of California, Los Angeles · USLos Angeles County Department of Public Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: To report an image analysis pipeline, DDLSNet, consisting of a rim segmentation (RimNet) branch and a disc size classification (DiscNet) branch to automate estimation of the disc damage likelihood scale (DDLS). Design: Retrospective observational. Participants: RimNet and DiscNet were developed with 1208 and 11 536 optic disc photographs (ODPs), respectively. DDLSNet performance was evaluated on 120 ODPs from the RimNet test set, for which the DDLS scores were graded by clinicians. Reproducibility was evaluated on a group of 781 eyes, each with 2 ODPs taken within 4 years apart. Methods: Disc damage likelihood scale calculation requires estimation of optic disc size, provided by DiscNet (VGG19 network), and the minimum rim-to-disc ratio (mRDR) or absent rim width (ARW), provided by RimNet (InceptionV3/LinkNet segmentation model). To build RimNet's dataset, glaucoma specialists marked optic disc rim and cup boundaries on ODPs. The "ground truth" mRDR or ARW was calculated. For DiscNet's dataset, corresponding OCT images provided "ground truth" disc size. Optic disc photographs were split into 80/10/10 for training, validation, and testing, respectively, for RimNet and DiscNet. DDLSNet estimation was tested against manual grading of DDLS by clinicians with the average score used as "ground truth." Reproducibility of DDLSNet grading was evaluated by repeating DDLS estimation on a dataset of nonprogressing paired ODPs taken at separate times. Main Outcome Measures: The main outcome measure was a weighted kappa score between clinicians and the DDLSNet pipeline with agreement defined as ± 1 DDLS score difference. Results: RimNet achieved an mRDR mean absolute error (MAE) of 0.04 (± 0.03) and an ARW MAE of 48.9 (± 35.9) degrees when compared to clinician segmentations. DiscNet achieved 73% (95% confidence interval [CI]: 70%, 75%) classification accuracy. DDLSNet achieved an average weighted kappa agreement of 0.54 (95% CI: 0.40, 0.68) compared to clinicians. Average interclinician agreement was 0.52 (95% CI: 0.49, 0.56). Reproducibility testing demonstrated that 96% of ODP pairs had a difference of Conclusions: DDLSNet achieved moderate agreement with clinicians for DDLS grading. This novel approach illustrates the feasibility of automated ODP grading for assessing glaucoma severity. Further improvements may be achieved by increasing the number of incomplete rims sample size, expanding the hyperparameter search, and increasing the agreement of clinicians grading ODPs.

Indexed as

ARW, absent rim widthCI, confidence intervalDDLSDDLS, disc damage likelihood scaleDiscNet, disc size classification modelGlaucomaMAE, mean average errormRDR, minimum rim-to-disc ratioNeural networkODP, optic disc photographRimIoU, rim intersection over unionRimNet, rim segmentation modelSegmentation

Identifiers

PMID36619716
PMCPMC9813574
OpenAlexW4308783435

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.