ArticleNature medicine2024
Integrated image-based deep learning and language models for primary diabetes care.
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Article in Nature medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 113 papers, 3 of them syntheses that pooled it.
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113citing papers in PubMed, 3 pooled it
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Who cites it
113 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Large language models for primary care ophthalmic education: a systematic review.Frontiers in medicine · 2026Pooled it
- Evaluating Large Language Models in Ophthalmology: Systematic Review.Journal of medical Internet research · 2025Pooled it
- Trends and hotspots in the field of diabetic retinopathy imaging research from 2000-2023.Frontiers in medicine · 2024Pooled it
- The Underutilized Ocular Fundus in Emergency Departments: Current Progress and Future Prospect of Imaging and Artificial Intelligence for Patient Care.Ophthalmology science · 2026Review
- Generative large language models in medicine: a scoping review of recent methodological advances.npj health systems · 2026Review
- Inclusive Digital Health Strategies for Persons With Disabilities: A Scoping Review.JAMA network open · 2026Article
- Evidence, use cases, and implementation safeguards of large language models in primary care.Communications medicine · 2026Review
- Article
- From generalization to precision: A large domain-specific pretrained model for specialized medical tasks.Cell reports. Medicine · 2026Article
- Neoadjuvant Chemoimmunotherapy Versus Standard Chemoradiotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma.Annals of surgical oncology · 2026Article
- Stepwise Diagnostic Evaluation of Chinese Large Language Models: Comparative Study of Common and Rare Diseases.Journal of medical Internet research · 2026Article
- A decade of artificial intelligence research in ophthalmology: Global trends and transferable insights for medical AI.PLOS digital health · 2026Article
- Advances in diagnosing and treating diabetic retinopathy.Nature reviews. Endocrinology · 2026Review
- A Multiagent Large Language Model Framework for Emergency Treatment Recommendation in Acute Ischemic Stroke: Development and Validation Study.Journal of medical Internet research · 2026Article
- A multimodal vision-language model for comprehensive dental diagnosis and enhanced clinical practice.Nature communications · 2026Article
- Toward Reliable Diabetic Retinopathy Screening.Sensors (Basel, Switzerland) · 2026Article
- A scalable deep-learning framework for cancer detection using cell-free DNA shallow whole-genome sequencing.Science advances · 2026Article
- Development of a multimodal large language model for early warning and diagnosis of chronic ocular GVHD.NPJ digital medicine · 2026Article
- Plasma proteomic signatures of early retinal neurodegeneration in diabetes: A multi-cohort study.PLoS medicine · 2026Observational
- Impact of artificial intelligence on the availability, accessibility, acceptability and quality of ophthalmic disease screening services: a scoping review.The British journal of ophthalmology · 2026Article
53 more citing papers are in PubMed but not listed here.
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Authors and funding
93 authors.
Jiajia Li *Shanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Zhouyu Guan *Shanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.ORCID http://orcid.org/0009-0008-5102-0067
Jing Wang *Department of Ophthalmology, Huadong Sanatorium, Wuxi, China.
Carol Y CheungDepartment of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Yingfeng ZhengState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
Lee-Ling LimDepartment of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.ORCID http://orcid.org/0000-0002-6214-6924
Cynthia Ciwei LimDepartment of Renal Medicine, Singapore General Hospital, SingHealth-Duke Academic Medical Centre, Singapore, Singapore.
Paisan RuamviboonsukFaculty of Medicine, Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
Rajiv RamanShri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India.
Leonor CorsinoDepartment of Medicine, Division of Endocrinology, Metabolism and Nutrition, and Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Justin B Echouffo-TcheuguiDepartment of Medicine, Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Andrea O Y LukDepartment of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Li Jia ChenDepartment of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.ORCID http://orcid.org/0000-0003-3500-5840
Xiaodong SunDepartment of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID http://orcid.org/0000-0001-5015-0945
Haslina HamzahSingapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
Qiang WuDepartment of Ophthalmology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Xiangning WangDepartment of Ophthalmology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID http://orcid.org/0000-0003-2608-9026
Ruhan LiuShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.ORCID http://orcid.org/0000-0002-0281-8039
Ya Xing WangBeijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.ORCID http://orcid.org/0000-0003-2749-7793
Tingli ChenDepartment of Ophthalmology, Huadong Sanatorium, Wuxi, China.
Xiao ZhangThe People's Hospital of Sixian County, Anhui, China.
Xiaolong YangDepartment of Ophthalmology, Huadong Sanatorium, Wuxi, China.
Jun YinShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Jing WanDepartment of Endocrinology and Metabolism, Shanghai Eighth People's Hospital, Shanghai, China.
Wei DuDepartment of Endocrinology and Metabolism, Shanghai Eighth People's Hospital, Shanghai, China.
Ten Cheer QuekSingapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
Jocelyn Hui Lin GohSingapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
Dawei YangDepartment of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Xiaoyan HuDepartment of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Truong X NguyenDepartment of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.ORCID http://orcid.org/0000-0002-8505-6593
Simon K H SzetoDepartment of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.ORCID http://orcid.org/0000-0001-9377-7377
Peranut ChotcomwongseFaculty of Medicine, Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
Rachid MalekDepartment of Internal Medicine, Setif University Ferhat Abbas, Setif, Algeria.
Nargiza NormatovaOphthalmology Department at Tashkent Advanced Training Institute for Doctors, Tashkent, Uzbekistan.
Nilufar IbragimovaCharity Union of Persons with Disabilities and People with Diabetes UMID, Tashkent, Uzbekistan.
Ramyaa SrinivasanShri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India.
Pingting ZhongState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
Wenyong HuangState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.ORCID http://orcid.org/0000-0003-3167-0851
Chenxin DengDepartment of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Lei RuanDepartment of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Cuntai ZhangDepartment of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Chenxi ZhangDepartment of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Yan ZhouDepartment of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Chan WuDepartment of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Rongping DaiDepartment of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Sky Wei Chee KohNational University Polyclinics, National University Health System, Department of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.ORCID http://orcid.org/0000-0003-4520-646X
Adina AbdullahDepartment of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Nicholas Ken Yoong HeeDepartment of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
Hong Chang TanDepartment of Endocrinology, Singapore General Hospital, Singapore, Singapore.
Zhong Hong LiewDepartment of Renal Medicine, Singapore General Hospital, SingHealth-Duke Academic Medical Centre, Singapore, Singapore.
Carolyn Shan-Yeu TienDepartment of Renal Medicine, Singapore General Hospital, SingHealth-Duke Academic Medical Centre, Singapore, Singapore.ORCID http://orcid.org/0000-0002-6554-2703
Shih Ling KaoDivision of Endocrinology, University Medicine Cluster, National University Health System, Singapore, Singapore.
Amanda Yuan Ling LimDivision of Endocrinology, University Medicine Cluster, National University Health System, Singapore, Singapore.ORCID http://orcid.org/0000-0001-7488-0985
Shao Feng MokDivision of Endocrinology, University Medicine Cluster, National University Health System, Singapore, Singapore.
Lina SunDepartment of Internal Medicine, Huadong Sanatorium, Wuxi, China.
Jing GuDepartment of Internal Medicine, Huadong Sanatorium, Wuxi, China.
Liang WuShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Tingyao LiShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Di ChengShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Zheyuan WangShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Yiming QinShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.ORCID http://orcid.org/0000-0001-8831-1644
Ling DaiShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.ORCID http://orcid.org/0000-0002-2000-8363
Ziyao MengShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Jia ShuShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Yuwei LuShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Nan JiangShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Tingting HuShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Shan HuangShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Gengyou HuangShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Shujie YuShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Dan LiuShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Weizhi MaInstitute for AI Industry Research, Tsinghua University, Beijing, China.ORCID http://orcid.org/0000-0001-5604-7527
Minyi GuoShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Xinping GuanDepartment of Automation and the Key Laboratory of System Control and Information Processing, Ministry of Education of China, Shanghai Jiao Tong University, Shanghai, China.
Xiaokang YangMOE Key Laboratory of AI, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China.ORCID http://orcid.org/0000-0003-4029-3322
Covadonga BascaranInternational Centre for Eye Health, London School of Hygiene and Tropical Medicine, University of London, London, UK.
Charles R ClelandInternational Centre for Eye Health, London School of Hygiene and Tropical Medicine, University of London, London, UK.
Yuqian BaoShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
Elif I EkinciDepartment of Endocrinology, Austin Health, Melbourne, Victoria, Australia.
Alicia JenkinsAustralian Centre for Accelerating Diabetes Innovations, The University of Melbourne, Parkville, Victoria, Australia.ORCID http://orcid.org/0000-0003-0583-3717
Juliana C N ChanDepartment of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.ORCID http://orcid.org/0000-0003-1325-1194
Yong Mong BeeDepartment of Endocrinology, Singapore General Hospital, Singapore, Singapore.ORCID http://orcid.org/0000-0002-5482-2646
Sobha SivaprasadNIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.
Jonathan E ShawDepartment of Medicine, The University of Melbourne (Austin Health), Melbourne, Victoria, Australia.
Rafael SimóCentro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain.ORCID http://orcid.org/0000-0003-0475-3096
Pearse A KeaneNIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.ORCID http://orcid.org/0000-0002-9239-745X
Ching-Yu ChengSingapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.ORCID http://orcid.org/0000-0003-0655-885X
Gavin Siew Wei TanSingapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
Weiping JiaShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China. wpjia@sjtu.edu.cn.ORCID http://orcid.org/0000-0002-6244-2168
Yih-Chung ThamSingapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. thamyc@nus.edu.sg.ORCID http://orcid.org/0000-0002-6752-797X
Huating LiShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China. huarting99@sjtu.edu.cn.ORCID http://orcid.org/0000-0003-0526-5545
Bin ShengShanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China. shengbin@sjtu.edu.cn.ORCID http://orcid.org/0000-0001-8510-2556
Tien Yin WongSingapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. wongtienyin@tsinghua.edu.cn.ORCID http://orcid.org/0000-0002-8448-1264
Funding
New York Regional Center for Diabetes Translation Research - Translational Intervention Methodology CoreP30DK111022 · NIDDK · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI JEFFREY GONZALEZ · 2016 to 2026
$7.8MNIDDK NIH HHS P30 DK111022
Abstract
Primary diabetes care and diabetic retinopathy (DR) screening persist as major public health challenges due to a shortage of trained primary care physicians (PCPs), particularly in low-resource settings. Here, to bridge the gaps, we developed an integrated image-language system (DeepDR-LLM), combining a large language model (LLM module) and image-based deep learning (DeepDR-Transformer), to provide individualized diabetes management recommendations to PCPs. In a retrospective evaluation, the LLM module demonstrated comparable performance to PCPs and endocrinology residents when tested in English and outperformed PCPs and had comparable performance to endocrinology residents in Chinese. For identifying referable DR, the average PCP's accuracy was 81.0% unassisted and 92.3% assisted by DeepDR-Transformer. Furthermore, we performed a single-center real-world prospective study, deploying DeepDR-LLM. We compared diabetes management adherence of patients under the unassisted PCP arm (n = 397) with those under the PCP+DeepDR-LLM arm (n = 372). Patients with newly diagnosed diabetes in the PCP+DeepDR-LLM arm showed better self-management behaviors throughout follow-up (P < 0.05). For patients with referral DR, those in the PCP+DeepDR-LLM arm were more likely to adhere to DR referrals (P < 0.01). Additionally, DeepDR-LLM deployment improved the quality and empathy level of management recommendations. Given its multifaceted performance, DeepDR-LLM holds promise as a digital solution for enhancing primary diabetes care and DR screening.
Indexed as
Deep LearningDiabetes MellitusDiabetic RetinopathyPrimary Health CareAdultAgedFemaleHumansLanguageMaleMiddle AgedPhysicians, Primary CareProspective StudiesRetrospective Studies
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