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Deep Learning System Outperforms Clinicians in Identifying Optic Disc Abnormalities.

Caroline Vasseneix1, Simon Nusinovici, Xinxing Xu

  • 1Visual Neuroscience Group (CV, SN, DT, TYW, DM, RPN), Singapore Eye Research Institute, Singapore; Duke NUS Medical School (DT, TYW, DM, RPN), National University of Singapore, Singapore; Institute of High Performance Computing (XX, YL), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Ophthalmology (J-MH), Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea (the Republic of); Department of Ophthalmology (SH), Rigshospitalet, University of Copenhagen, Kobenhavn, Denmark ; Departments of Ophthalmology and Neurology (JJC), Mayo Clinic Rochester, Minnesota; Singapore National Eye Centre (JLL, DT, TYW, DM), Singapore; Berkeley University (LM), Berkeley, California; Department of Emergency Medicine (KT), Singapore General Hospital, Singapore; Departments of Ophthalmology, Neurology and Neurological Surgery (NJN, VB), Emory University School of Medicine, Atlanta, Georgia; and Department of Ophthalmology (RPN), Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
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Summary
This summary is machine-generated.

An artificial intelligence system (BONSAI-DLS) accurately detects optic disc abnormalities, outperforming clinicians in classifying conditions like papilledema. This AI tool can aid diverse medical professionals in screening for serious neurological conditions.

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Area of Science:

  • Ophthalmology
  • Artificial Intelligence
  • Medical Diagnostics

Background:

  • Optic disc examination is crucial for neurological symptoms but often neglected in general clinics.
  • Existing AI systems show promise, but their performance against frontline clinicians is unproven.

Purpose of the Study:

  • To evaluate the diagnostic performance of the BONSAI-DLS compared to various clinicians.
  • To assess the AI's accuracy in detecting optic disc abnormalities, including papilledema.

Main Methods:

  • A multicenter study tested the BONSAI-DLS on 800 fundus photographs.
  • The AI's performance was compared against 30 clinicians (ophthalmologists, optometrists, neurologists, internists, ED physicians).
  • Error rates, accuracy, sensitivity, and specificity were calculated for both AI and clinicians.

Main Results:

  • The BONSAI-DLS achieved a 15.3% error rate, significantly outperforming all clinician groups.
  • AI demonstrated superior accuracy in classifying papilledema, normal discs, and other abnormalities compared to clinicians.
  • The AI's classification performance was comparable to expert neuro-ophthalmologists.

Conclusions:

  • The BONSAI-DLS exhibits superior performance in classifying optic discs compared to clinicians.
  • This AI system can serve as a valuable diagnostic aid for screening optic disc abnormalities in various clinical settings.
  • Early detection of sight- or life-threatening neurological conditions can be improved with AI assistance.