Diagnostic performance of deep-learning-based screening methods for diabetic retinopathy in primary care-A meta-analysis.

Abstract

BackgroundDiabetic retinopathy (DR) affects 10-24% of patients with diabetes mellitus type 1 or 2 in the primary care (PC) sector. As early detection is crucial for treatment, deep learning screening methods in PC setting could potentially aid in an accurate and timely diagnosis.PurposeThe purpose of this meta-analysis was to determine the current state of knowledge regarding deep learning (DL) screening methods for DR in PC.Data sourcesA systematic literature search was conducted using Medline, Web of Science, and Scopus to identify suitable studies.Study selectionSuitable studies were selected by two researchers independently. Studies assessing DL methods and the suitability of these screening systems (diagnostic parameters such as sensitivity and specificity, information on datasets and setting) in PC were selected. Excluded were studies focusing on lesions, applying conventional diagnostic imaging tools, conducted in secondary or tertiary care, and all publication types other than original research studies on human subjects.Data extractionThe following data was extracted from included studies: authors, title, year of publication, objectives, participants, setting, type of intervention/method, reference standard, grading scale, outcome measures, dataset, risk of bias, and performance measures.Data synthesis and conclusionThe summed sensitivity of all included studies was 87% and specificity was 90%. Given a prevalence of DR of 10% in patients with DM Type 2 in PC, the negative predictive value is 98% while the positive predictive value is 49%.LimitationsSelected studies showed a high variation in sample size and quality and quantity of available data.