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Remote Tool-Based Adjudication for Grading Diabetic Retinopathy.

Mike Schaekermann1,2, Naama Hammel1, Michael Terry1

  • 1Google AI Healthcare, Google LLC, Mountain View, CA, USA.

Translational Vision Science & Technology
|December 24, 2019
PubMed
Summary

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This summary is machine-generated.

Remote, tool-based diabetic retinopathy (DR) grading is a reliable alternative to in-person methods. A feature-based rubric speeds up consensus without affecting diagnostic quality.

Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Digital Health

Background:

  • Diabetic retinopathy (DR) diagnosis relies on expert grading of retinal images.
  • Current in-person adjudication methods can be time-consuming and resource-intensive.
  • There is a need for efficient and reliable remote solutions for DR assessment.

Purpose of the Study:

  • To evaluate a remote, tool-based system for adjudicating diabetic retinopathy (DR) grades.
  • To assess the effectiveness of a structured, feature-based grading rubric in this remote system.
  • To compare remote adjudication with traditional in-person methods.

Main Methods:

  • Compared three adjudication procedures: in-person (Baseline), remote tool-based (TA), and remote tool-based with feature rubric (TA-F).
Keywords:
adjudicationdiabetic retinopathyretinal imagingteleophthalmology

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  • Developed a system for remote, asynchronous image review by retina specialist panels.
  • Measured reliability using Cohen's kappa and efficiency by the number of consensus rounds.

    • Main Results:

    • Remote adjudication (TA and TA-F) demonstrated high agreement with the in-person Baseline procedure (kappa scores > 0.92).
    • The feature-based rubric (TA-F) significantly reduced the number of rounds needed for consensus compared to TA (P < 0.001).
    • Remote, tool-based adjudication proved reliable and efficient.

    Conclusions:

    • Remote, tool-based adjudication is a flexible and dependable alternative for DR diagnosis.
    • Feature-based rubrics enhance the efficiency of remote DR adjudication without sacrificing quality.
    • This system can support automated method validation and telemedical workflows.