Evidence map›Paper›PMID 40613078›Full record

ArticleFrontiers in digital health2025

Improving diabetic retinopathy screening using artificial intelligence: design, evaluation and before-and-after study of a custom development.

Imanol Pinto, Álvaro Olazarán, David Jurío, Borja De la Osa, Miguel Sainz, Aritz Oscoz, Jerónimo Ballaz, Javier Gorricho, Mikel Galar, José Andonegui

Abstract read
In one paragraph

Article in Frontiers in digital health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Review
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

10 authors.

Imanol PintoHealth Technology Services, General Directorate of Telecommunications and Digitalization (DGTD), Sarriguren, Spain.
Álvaro OlazaránHealth Technology Services, General Directorate of Telecommunications and Digitalization (DGTD), Sarriguren, Spain.
David JuríoHealth Technology Services, General Directorate of Telecommunications and Digitalization (DGTD), Sarriguren, Spain.
Borja De la OsaHealth Technology Services, General Directorate of Telecommunications and Digitalization (DGTD), Sarriguren, Spain.
Miguel SainzHealth Technology Services, General Directorate of Telecommunications and Digitalization (DGTD), Sarriguren, Spain.
Aritz OscozHealth Technology Services, General Directorate of Telecommunications and Digitalization (DGTD), Sarriguren, Spain.
Jerónimo BallazHealth Technology Services, General Directorate of Telecommunications and Digitalization (DGTD), Sarriguren, Spain.
Javier GorrichoHealth Outcomes Evaluation and Dissemination Service, Navarre Public Health Service (SNS-O), Pamplona, Spain.
Mikel GalarNavarre Institute of Health Research, IdiSNA, Pamplona, Spain.
José AndoneguiNavarre Institute of Health Research, IdiSNA, Pamplona, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The worst outcomes of diabetic retinopathy (DR) can be prevented by implementing DR screening programs assisted by AI. At the University Hospital of Navarre (HUN), Spain, general practitioners (GPs) grade fundus images in an ongoing DR screening program, referring to a second screening level (ophthalmologist) target patients. Methods: After collecting their requirements, HUN decided to develop a custom AI tool, called NaIA-RD, to assist their GPs in DR screening. This paper introduces NaIA-RD, details its implementation, and highlights its unique combination of DR and retinal image quality grading in a single system. Its impact is measured in an unprecedented before-and-after study that compares 19,828 patients screened before NaIA-RD's implementation and 22,962 patients screened after. Results: NaIA-RD influenced the screening criteria of 3/4 GPs, increasing their sensitivity. Agreement between NaIA-RD and the GPs was high for non-referral proposals (94.6% or more), but lower and variable (from 23.4% to 86.6%) for referral proposals. An ophthalmologist discarded a NaIA-RD error in most of contradicted referral proposals by labeling the 93% of a sample of them as referable. In an autonomous setup, NaIA-RD would have reduced the study visualization workload by 4.27 times without missing a single case of sight-threatening DR referred by a GP. Conclusion: DR screening was more effective when supported by NaIA-RD, which could be safely used to autonomously perform the first level of screening. This shows how AI devices, when seamlessly integrated into clinical workflows, can help improve clinical pathways in the long term.

Indexed as

AI medical devicebefore-and-after studydecision-support systemdeep learningdiabetic retinopathy

Identifiers

PMID40613078
PMCPMC12222278

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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.