Open Access在真实世界研究中深度学习算法在糖尿病视网膜病变诊断中的分层分析
Author(s) -
Li Na,
Ma Mingming,
Lai Mengyu,
Gu Liping,
Kang Mei,
Wang Zilong,
Jiao Shengyin,
Dang Kang,
Deng Junxiao,
Ding Xiaowei,
Zhen Qin,
Zhang Aifang,
Shen Tingting,
Zheng Zhi,
Wang Yufan,
Peng Yongde
Publication year - 2022
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.13241
Subject(s) - medicine , diabetic retinopathy , diabetes mellitus , type 2 diabetes , receiver operating characteristic , diabetic nephropathy , creatinine , retinopathy , renal function , algorithm , nephropathy , blood pressure , ophthalmology , endocrinology , computer science
Background The aim of our research was to prospectively explore the clinical value of a deep learning algorithm (DLA) to detect referable diabetic retinopathy (DR) in different subgroups stratified by types of diabetes, blood pressure, sex, BMI, age, glycosylated hemoglobin (HbA1c), diabetes duration, urine albumin‐to‐creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR) at a real‐world diabetes center in China. Methods A total of 1147 diabetic patients from Shanghai General Hospital were recruited from October 2018 to August 2019. Retinal fundus images were graded by the DLA, and the detection of referable DR (moderate nonproliferative DR or worse) was compared with a reference standard generated by one certified retinal specialist with more than 12 years of experience. The performance of DLA across different subgroups stratified by types of diabetes, blood pressure, sex, BMI, age, HbA1c, diabetes duration, UACR, and eGFR was evaluated. Results For all 1674 gradable images, the area under the receiver operating curve, sensitivity, and specificity of the DLA for referable DR were 0.942 (95% CI, 0.920‐0.964), 85.1% (95% CI, 83.4%‐86.8%), and 95.6% (95% CI, 94.6%‐96.6%), respectively. The DLA showed consistent performance across most subgroups, while it showed superior performance in the subgroups of patients with type 1 diabetes, UACR ≥ 30 mg/g, and eGFR < 90 mL/min/1.73m 2 . Conclusions This study showed that the DLA was a reliable alternative method for the detection of referable DR and performed superior in patients with type 1 diabetes and diabetic nephropathy who were prone to DR.