Automated artificial intelligence-based system for clinical follow-up of patients with age-related macular degeneration
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Automated artificial intelligence-based system for clinical follow-up of patients with age-related macular degeneration. / Potapenko, Ivan; Thiesson, Bo; Kristensen, Mads; Hajari, Javad Nouri; Ilginis, Tomas; Fuchs, Josefine; Hamann, Steffen; la Cour, Morten.
In: Acta Ophthalmologica, Vol. 100, No. 8, 2022, p. 927-936.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Automated artificial intelligence-based system for clinical follow-up of patients with age-related macular degeneration
AU - Potapenko, Ivan
AU - Thiesson, Bo
AU - Kristensen, Mads
AU - Hajari, Javad Nouri
AU - Ilginis, Tomas
AU - Fuchs, Josefine
AU - Hamann, Steffen
AU - la Cour, Morten
N1 - Publisher Copyright: © 2022 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.
PY - 2022
Y1 - 2022
N2 - Purpose: In this study, we investigate the potential of a novel artificial intelligence-based system for autonomous follow-up of patients treated for neovascular age-related macular degeneration (AMD). Methods: A temporal deep learning model was trained on a data set of 84 489 optical coherence tomography scans from AMD patients to recognize disease activity, and its performance was compared with a published non-temporal model trained on the same data (Acta Ophthalmol, 2021). An autonomous follow-up system was created by augmenting the AI model with deterministic logic to suggest treatment according to the observe-and-plan regimen. To validate the AI-based system, a data set comprising clinical decisions and imaging data from 200 follow-up consultations was collected prospectively. In each case, both the autonomous AI decision and original clinical decision were compared with an expert panel consensus. Results: The temporal AI model proved superior at detecting disease activity compared with the model without temporal input (area under the curve 0.900 (95% CI 0.894–0.906) and 0.857 (95% CI 0.846–0.867) respectively). The AI-based follow-up system could make an autonomous decision in 73% of the cases, 91.8% of which were in agreement with expert consensus. This was on par with the 87.7% agreement rate between decisions made in the clinic and expert consensus (p = 0.33). Conclusions: The proposed autonomous follow-up system was shown to be safe and compliant with expert consensus on par with clinical practice. The system could in the future ease the pressure on public ophthalmology services from an increasing number of AMD patients.
AB - Purpose: In this study, we investigate the potential of a novel artificial intelligence-based system for autonomous follow-up of patients treated for neovascular age-related macular degeneration (AMD). Methods: A temporal deep learning model was trained on a data set of 84 489 optical coherence tomography scans from AMD patients to recognize disease activity, and its performance was compared with a published non-temporal model trained on the same data (Acta Ophthalmol, 2021). An autonomous follow-up system was created by augmenting the AI model with deterministic logic to suggest treatment according to the observe-and-plan regimen. To validate the AI-based system, a data set comprising clinical decisions and imaging data from 200 follow-up consultations was collected prospectively. In each case, both the autonomous AI decision and original clinical decision were compared with an expert panel consensus. Results: The temporal AI model proved superior at detecting disease activity compared with the model without temporal input (area under the curve 0.900 (95% CI 0.894–0.906) and 0.857 (95% CI 0.846–0.867) respectively). The AI-based follow-up system could make an autonomous decision in 73% of the cases, 91.8% of which were in agreement with expert consensus. This was on par with the 87.7% agreement rate between decisions made in the clinic and expert consensus (p = 0.33). Conclusions: The proposed autonomous follow-up system was shown to be safe and compliant with expert consensus on par with clinical practice. The system could in the future ease the pressure on public ophthalmology services from an increasing number of AMD patients.
KW - age-related macular degeneration
KW - anti-vegf
KW - artificial intelligence
KW - follow-up
U2 - 10.1111/aos.15133
DO - 10.1111/aos.15133
M3 - Journal article
C2 - 35322564
AN - SCOPUS:85126857106
VL - 100
SP - 927
EP - 936
JO - Acta Ophthalmologica
JF - Acta Ophthalmologica
SN - 1755-375X
IS - 8
ER -
ID: 312768154