Population impact and cost-effectiveness of artificial intelligence-based diabetic retinopathy screening in people living with diabetes in Australia: a cost effectiveness analysis

Hu, Wenyi; Joseph, Sanil; Li, Rui; Woods, Ekaterina; Sun, Jason; Shen, Mingwang; Jan, Catherine Lingxue; Zhu, Zhuoting; He, Mingguang; Zhang, Lei

doi:10.1016/j.eclinm.2023.102387

Cited by 3 publications

(1 citation statement)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, the use of artificial intelligence (AI) tools, particularly deep learning techniques such as convolutional neural networks (CNN), has been introduced in the healthcare sector. The AI approaches have shown promising results in assisting screening and diagnosis [ 16 – 18 ] and demonstrated good cost-effectiveness in implementation [ 19 – 21 ]. For example, studies have demonstrated that CNN can accurately distinguish between different skin lesions from dermoscopic and clinical images [ 22 – 26 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of artificial intelligence-powered screening for sexually transmitted infections-related skin lesions using clinical images and metadata

Soe,

Yu,

Latt

et al. 2024

BMC Med

View full text Add to dashboard Cite

Background Sexually transmitted infections (STIs) pose a significant global public health challenge. Early diagnosis and treatment reduce STI transmission, but rely on recognising symptoms and care-seeking behaviour of the individual. Digital health software that distinguishes STI skin conditions could improve health-seeking behaviour. We developed and evaluated a deep learning model to differentiate STIs from non-STIs based on clinical images and symptoms. Methods We used 4913 clinical images of genital lesions and metadata from the Melbourne Sexual Health Centre collected during 2010–2023. We developed two binary classification models to distinguish STIs from non-STIs: (1) a convolutional neural network (CNN) using images only and (2) an integrated model combining both CNN and fully connected neural network (FCN) using images and metadata. We evaluated the model performance by the area under the ROC curve (AUC) and assessed metadata contributions to the Image-only model. Results Our study included 1583 STI and 3330 non-STI images. Common STI diagnoses were syphilis (34.6%), genital warts (24.5%) and herpes (19.4%), while most non-STIs (80.3%) were conditions such as dermatitis, lichen sclerosis and balanitis. In both STI and non-STI groups, the most frequently observed groups were 25–34 years (48.6% and 38.2%, respectively) and heterosexual males (60.3% and 45.9%, respectively). The Image-only model showed a reasonable performance with an AUC of 0.859 (SD 0.013). The Image + Metadata model achieved a significantly higher AUC of 0.893 (SD 0.018) compared to the Image-only model (p < 0.01). Out of 21 metadata, the integration of demographic and dermatological metadata led to the most significant improvement in model performance, increasing AUC by 6.7% compared to the baseline Image-only model. Conclusions The Image + Metadata model outperformed the Image-only model in distinguishing STIs from other skin conditions. Using it as a screening tool in a clinical setting may require further development and evaluation with larger datasets.

show abstract

Section: Introductionmentioning

confidence: 99%

Evaluation of artificial intelligence-powered screening for sexually transmitted infections-related skin lesions using clinical images and metadata

Soe,

Yu,

Latt

et al. 2024

BMC Med

View full text Add to dashboard Cite

show abstract

Novel artificial intelligence for diabetic retinopathy and diabetic macular edema: what is new in 2024?

Vujosevic,

Limoli,

Nucci

2024

Current Opinion in Ophthalmology

View full text Add to dashboard Cite

Purpose of review Given the increasing global burden of diabetic retinopathy and the rapid advancements in artificial intelligence, this review aims to summarize the current state of artificial intelligence technology in diabetic retinopathy detection and management, assessing its potential to improve care and visual outcomes in real-world settings. Recent findings Most recent studies focused on the integration of artificial intelligence in the field of diabetic retinopathy screening, focusing on real-world efficacy and clinical implementation of such artificial intelligence models. Additionally, artificial intelligence holds the potential to predict diabetic retinopathy progression, enhance personalized treatment strategies, and identify systemic disease biomarkers from ocular images through ‘oculomics’, moving towards a more precise, efficient, and accessible care. The emergence of foundation model architectures and generative artificial intelligence, which more clearly reflect the clinical care process, may enable rapid advances in diabetic retinopathy care, research and medical education. Summary This review explores the emerging technology of artificial intelligence to assess the potential to improve patient outcomes and optimize personalized management in healthcare delivery and medical research. While artificial intelligence is expected to play an increasingly important role in diabetic retinopathy care, ongoing research and clinical trials are essential to address implementation issues and focus on long-term patient outcomes for successful real-world adoption of artificial intelligence in diabetic retinopathy.

show abstract

Economic evaluations of eye care services for Indigenous populations in high-income countries: a scoping review

Nejatian,

Sincari,

Alam

et al. 2024

Int J Equity Health

View full text Add to dashboard Cite

Background Indigenous people in high-income countries have worse eye health outcomes when compared to non-Indigenous people, contributing to ongoing socioeconomic disadvantage. Although services have been designed to address these disparities, it is unclear if they have undergone comprehensive economic evaluation. Our scoping review aimed to identify the number, type, quality, and main findings of such evaluations. Methods MEDLINE, Embase, Web of Science, Cochrane Library Database, the National Health Service Economic Evaluation Database, EconLit, and relevant grey literature were systematically searched as per our pre-registered protocol. All economic evaluations of real or model services designed to meet the eye care needs of Indigenous populations in high-income countries were included. Two reviewers independently screened studies, extracted data, and assessed quality using the Quality of Health Economic Studies instrument. Results We identified 20 studies evaluating services for Indigenous populations in Australia (n = 9), Canada (n = 7), and the United States of America (n = 4). Common services included diabetic retinopathy (DR) screening through fundus photographs acquired in local primary health care clinics (n = 7) or by mobile teams (n = 6), and general eye care through teleophthalmology (n = 2), outreach ophthalmology (n = 2) or an Indigenous health care clinic optometrist (n = 1). These services were economically favourable in 85% of comparisons with conventional alternatives, mainly through reduced costs of travel, in-person consults, and vision loss. Only four studies assessed the benefits of increased patient uptake. Only five included patient evaluations, but none integrated these into their quantitative analysis. Methodological issues included no stated economic perspective (n = 10), no sensitivity analysis (n = 12), no discounting (n = 9), inappropriate measurement of costs (n = 13) or outcomes (n = 5), and unjustified assumptions (n = 15). Conclusion Several Indigenous eye care services are cost-effective, particularly remote DR screening. Other services are promising but require evaluation, with attention to avoid common methodological pitfalls. Well-designed evaluations can guide the allocation of scarce resources to services with demonstrated effectiveness and sustainability. Trial registration Our scoping review protocol was pre-registered (Open Science Framework DOI: https://doi.org/10.17605/OSF.IO/YQKWN).

show abstract

Population impact and cost-effectiveness of artificial intelligence-based diabetic retinopathy screening in people living with diabetes in Australia: a cost effectiveness analysis

Cited by 3 publications

References 45 publications

Evaluation of artificial intelligence-powered screening for sexually transmitted infections-related skin lesions using clinical images and metadata

Evaluation of artificial intelligence-powered screening for sexually transmitted infections-related skin lesions using clinical images and metadata

Novel artificial intelligence for diabetic retinopathy and diabetic macular edema: what is new in 2024?

Economic evaluations of eye care services for Indigenous populations in high-income countries: a scoping review

Contact Info

Product

Resources

About