Development and international validation of custom-engineered and code-free deep-learning models for detection of plus disease in retinopathy of prematurity: a retrospective study.

Journal: The Lancet. Digital health
PMID: 37088692

Abstract

BACKGROUND: Retinopathy of prematurity (ROP), a leading cause of childhood blindness, is diagnosed through interval screening by paediatric ophthalmologists. However, improved survival of premature neonates coupled with a scarcity of available experts has raised concerns about the sustainability of this approach. We aimed to develop bespoke and code-free deep learning-based classifiers for plus disease, a hallmark of ROP, in an ethnically diverse population in London, UK, and externally validate them in ethnically, geographically, and socioeconomically diverse populations in four countries and three continents. Code-free deep learning is not reliant on the availability of expertly trained data scientists, thus being of particular potential benefit for low resource health-care settings.

Authors

  • Siegfried K Wagner
    National Institute for Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
  • Bart Liefers
    Diagnostic Image Analysis Group, Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: Bart.Liefers@radboudumc.nl.
  • Meera Radia
    Moorfields Eye Hospital NHS Foundation Trust, London, UK.
  • Gongyu Zhang
    NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, London, UK.
  • Robbert Struyven
    NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, London, UK.
  • Livia Faes
    Moorfields Eye Hospital NHS Foundation Trust, London, UK; Eye Clinic, Cantonal Hospital of Lucerne, Lucerne, Switzerland.
  • Jonathan Than
    Moorfields Eye Hospital NHS Foundation Trust, London, UK.
  • Shafi Balal
    Moorfields Eye Hospital NHS Foundation Trust, London, UK.
  • Charlie Hennings
    Moorfields Eye Hospital NHS Foundation Trust, London, UK.
  • Caroline Kilduff
    Moorfields Eye Hospital NHS Foundation Trust, London, UK.
  • Pakinee Pooprasert
    Moorfields Eye Hospital NHS Foundation Trust, London, UK.
  • Sophie Glinton
    NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, London, UK.
  • Meena Arunakirinathan
    Moorfields Eye Hospital NHS Foundation Trust, London, UK.
  • Periklis Giannakis
    Institute of Health Sciences Education, Queen Mary University of London, London, UK.
  • Imoro Zeba Braimah
    Lions International Eye Centre, Korle-Bu Teaching Hospital, Accra, Ghana.
  • Islam S H Ahmed
    Faculty of Medicine, Alexandria University, Alexandria, Egypt; Alexandria University Hospital, Alexandria, Egypt.
  • Mariam Al-Feky
    Department of Ophthalmology, Ain Shams University Hospitals, Cairo, Egypt; Watany Eye Hospital, Cairo, Egypt.
  • Hagar Khalid
    National Institute for Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS (National Health Service) Foundation Trust, London, United Kingdom.
  • Daniel Ferraz
    Institute of Ophthalmology, University College London, London, UK; D'Or Institute for Research and Education, São Paulo, Brazil.
  • Juliana Vieira
    Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
  • Rodrigo Jorge
    Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
  • Shahid Husain
    The Blizard Institute, Queen Mary University of London, London, UK; Neonatology Department, Homerton University Hospital NHS Foundation Trust, London, UK.
  • Janette Ravelo
    Neonatology Department, Homerton University Hospital NHS Foundation Trust, London, UK.
  • Anne-Marie Hinds
    Moorfields Eye Hospital NHS Foundation Trust, London, UK.
  • Robert Henderson
    UCL Great Ormond Street Institute of Child Health, University College London, London, UK; Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London, UK.
  • Himanshu I Patel
    Moorfields Eye Hospital NHS Foundation Trust, London, UK; The Royal London Hospital, Barts Health NHS Trust, London, UK.
  • Susan Ostmo
    Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon.
  • J Peter Campbell
    Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon.
  • Nikolas Pontikos
    University College London Institute of Ophthalmology, London, UK n.pontikos@ucl.ac.uk.
  • Praveen J Patel
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, London, United Kingdom.
  • Pearse A Keane
    National Institute for Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
  • Gill Adams
    NIHR Moorfields Biomedical Research Centre, London, UK; Moorfields Eye Hospital NHS Foundation Trust, London, UK.
  • Konstantinos Balaskas
    School of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom; Manchester Royal Eye Hospital, NHS Central Manchester University Hospitals, Manchester, United Kingdom.

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