摘要
目的:借助于人工智能(artificial intelligence,AI)眼底筛查远程接转诊系统,探索“患者-社区-医院”远程筛查模式,推进眼科分级诊疗和双向转诊实施,为地市级医疗机构开展眼底疾病人工智能筛查工作提供一定的经验借鉴。方法:通过AI辅助远程筛查基层医疗机构的4 886例患者,完成眼科检查并经AI初判、人工复核形成眼底诊断结论。通过医联体和专科联盟模式,对基层医疗机构的4 886例患者的AI诊断系统结果和上级医师审核结果进行对照分析,分析AI诊断系统在眼科常见病种筛查中的推广应用的可信度和可行性。结果:AI检出DR的灵敏度为94.70%,特异度96.06%;DME的灵敏度96.43%,特异度96.55%;AMD的灵敏度77.55%,特异度95.74%;同时,其在病理性近视、白内障、青光眼等常见病种眼底筛查中也有一定作用。结论:AI辅助远程筛查系统对于绝大多数眼底疾病有较高的敏感性和特异性,适用于眼底疾病的筛查工作,利于基层医院或社区医院对于眼底疾病的初步诊断,落实眼科分级诊疗,有借鉴推广意义。
Objective:With the help of artificial intelligence(AI)based fundus screening remote referral telemedicine system,it enables us to explore the remote screening mode of patient-community-hospital,and promote the two-way referral and ophthalmic graded diagnosis.This investigation provides certain practice experiences for prefecture-level medical institutions to carry out AI screening for fundus diseases.Methods:Ophthalmologic examination was performed on 4,886 patients in primary medical institutions through AI-aided remote screening,and the final fundus diagnosis conclusion was formed after AI preliminary judgment and manual review.Through the Medical Consortium and specialty alliance model,the results of the AI diagnosis system and the audit results of superior physicians for 4886 patients in primary care institutions were compared and analyzed,and the credibility and feasibility of the AI diagnosis system application in the screening of common ophthalmic diseases were discussed.Results:The sensitivity and specificity of AI detection of diabetic retinopathy were 94.70%and 96.06%,respectively.In the diabetic macular edema classification,the sensitivity and specificity were 96.43%and 96.55%,respectively.In the age-related macular degeneration classification,the sensitivity and specificity were 77.55%and 95.74%,respectively.Meanwhile,it also plays a role in screening common fundus diseases such as pathological myopia,cataract and glaucoma.Conclusions:The AIaided remote screening system has high sensitivity and specificity for most of fundus diseases,indicating it is promising for fundus diseases screening in primary medical institutions.It is conducive for primary hospitals or community hospitals to carry out the initial diagnosis of fundus diseases,as well as the implementation of graded diagnosis and treatment of ophthalmology,which has reference and promotion significance.
作者
刘延晶
王少鹏
徐喜卿
翟改霞
王作芬
封霄
LIU Yanjing;WANG Shaopeng;XU Xiqing;ZHAI Gaixia;WANG Zuofen;FENG Xiao(Zibo Central Hospital,Shandong Province,Zibo 255000,China)
出处
《眼科学报》
CAS
2023年第5期405-413,共9页
Eye Science
基金
淄博市重点研发项目(2019gy010046)~~。
关键词
人工智能
糖尿病视网膜病变
筛查
基层医疗
artificial intelligence
diabetic retinopathy
screening
primary medical services
