基于EasyDL开发糖尿病眼底病变人工智能分级诊断模型及其验证评价

Development of an artificial intelligent grading diagnosis model for diabetic fundus lesions based on EasyDL and its verification evaluation

  • 摘要: 目的 创新性利用人工智能(AI)开放平台EasyDL独立开发糖尿病视网膜病变(DR)的AI辅助诊断模型,并对其诊断准确指标进行评价。方法 采用Kaggle公开的糖尿病眼底疾病数据集的35 126张眼底照片作为训练集,上传至EasyDL开放平台建立AI辅助诊断模型。收集在眼科进行临床DR筛查的150例糖尿病患者共300张双眼的彩色眼底照片作为测试集,以3位副高及以上职称眼科医师的诊断为金标准,分别评价AI诊断模型、初级医师、中级医师及联合诊断对DR分级的诊断准确性。结果 非DR和轻度非增生型DR(NPDR)患者共170例,中度、重度NPDR和增生型DR(PDR)患者共130例。AI诊断模型灵敏度高但特异度低,各项诊断指标和中级医师诊断接近,比初级医师诊断优秀。当AI诊断模型和临床医师诊断相结合时,诊断的准确率和灵敏度均有所提高。在与金标准的一致性评价中,AI诊断模型的Kappa系数为1.00,而中级医师诊断的Kappa系数为0.88(P均< 0.01)。结论 基于开放平台EasyDL建立的AI诊断模型操作简单,能为DR的初筛提供帮助,同时也为不具备深度学习算法知识的临床医师提供有效的科研工具。

     

    Abstract: Objective To innovatively utilize the open artificial intelligence (AI) platform EasyDL to independently develop an AI auxiliary diagnosis model for diabetic retinopathy (DR), and evaluate its diagnostic accuracy indicators. Methods 35 126 fundus photos of the diabetes fundus disease data set published by Kaggle were used as the training set, and uploaded to the EasyDL open platform to establish an AI auxiliary diagnosis model. A total of 300 color fundus photographs of bilateral eyes of 150 patients with diabetes mellitus who received clinical DR screening were collected as the test set. The diagnosis of 3 ophthalmologists with deputy director title or above was considered as the gold standard. The diagnostic accuracy for the grading of DR by the AI diagnosis model, junior physicians, intermediate physicians and these combined was evaluated, respectively. Results There were 170 patients with non-DR (NDR) and mild non-proliferative DR (NPDR), and 130 patients with moderate and severe NPDR and proliferative DR (PDR). AI diagnostic model had high sensitivity but low specificity. AI diagnostic indexes were close to those of intermediate doctors and better than primary doctors. When AI diagnostic model was combined with physician diagnosis, the accuracy and sensitivity of diagnosis were improved. In the consistency evaluation with the gold standard, the Kappa coefficient of the AI diagnosis model was 1.00, and 0.88 for the intermediate physicians (both P < 0.01). Conclusions The AI diagnosis model based on the open platform EasyDL is simple and easy to operate, which can contribute to the preliminary screening of DR. It also provides effective scientific research tools for physicians who lack of the knowledge of deep learning algorithms.

     

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