Evidence map›Paper›PMID 41693809›Full record

ArticleOphthalmology science2026

Identifying Patients at High Risk of Lapses in Diabetic Retinopathy Care: A Machine Learning Study.

Jizhou Tian, Diep Tran, Zainab Rustam, Gina Zhu, Paul Nagy, Hadi Kharrazi, Deidra C Crews, Zitong Wang, Scott L Zeger, Cindy X Cai

Abstract read
In one paragraph

Article in Ophthalmology science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

10 authors.

Jizhou TianDepartment of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Diep TranWilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.
Zainab RustamWilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.
Gina ZhuWilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.
Paul NagyDepartment of Biomedical Informatics and Data Science, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Hadi KharraziCenter for Population Health Information Technology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Deidra C CrewsDepartment of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
Zitong WangDepartment of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Scott L ZegerDepartment of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Cindy X CaiWilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.

Funding

Impact of Social Determinants of Health in Diabetic RetinopathyK23EY033440 · NEI · JOHNS HOPKINS UNIVERSITY · PI Cindy Xinji Cai · 2022 to 2026
$1.1M
NEI NIH HHS K23 EY033440
6 · The paper itself

Abstract

Objective: To predict lapses in diabetic retinopathy (DR) care. Design: Retrospective cohort study. Subjects: Adults ≥18 years with diabetes seen at the Wilmer Eye Institute for DR screening or treatment between 2012 and 2022. Main Outcome Measures: Whether an office visit for DR screening or treatment was followed by a lapse in care. Methods: Three versions of prediction algorithms were constructed using random forests (RFs). XGBoost (XGB) was used as a confirmatory analysis. Random forest-A and XGB-A included electronic health record (EHR) variables alone (e.g., sociodemographic, insurance, ophthalmic diagnoses, lead time, and recommended follow-up time). Random forest-B and XGB-B added location-based social determinants of health (SDoH) variables (e.g., Area Deprivation Index). Random forest-C and XGB-C added history of lapses in care (e.g., whether the patient has ever had lapses in care before). The area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC) were calculated for each algorithm. Results: A total of 36 995 patients (mean age 62 years, 53% female, 47% non-Hispanic White, 38% non-Hispanic Black, and 4% Hispanic) and 141 930 office visits were included. The best performing model was RF-C with an AUROC of 0.774 (0.772-0.776) and AUPRC of 0.707 (0.704-0.711), outperforming RF-A and RF-B in AUROC and AUPRC ( Conclusions: We developed RF algorithms, as well as XGB confirmatory models, to predict whether patients with diabetes will experience a lapse in DR care. The best prediction was achieved using EHR variables, location-based SDoH variables, and history of lapses in care. These models offer the opportunity to identify high-risk patients and offer additional resources to reduce lapses in care and potentially vision loss from DR. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Indexed as

Diabetic retinopathyElectronic health recordLapses in carePredictionSocial determinants of health

Identifiers

PMID41693809
PMCPMC12902138

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.